Oregon Heart and Vascular Institute

Special Procedures

Cardiac catheterization team
prepares to start a procedure
in the Special Procedures Room.

Cardiologists perform a number of procedures in the Special Procedures Room, or Cath (catheterization) Lab. Each of these procedures is performed by means of a cardiac catheterization.
Coronary Arteriogram:	An X-ray examination of the coronary arteries. A catheter is placed into the coronary arteries to assess the arteries and the pumping chambers of the heart.
Percutaneous Transluminal Catheter Angioplasty:	The use of a balloon catheter placed in the coronary artery to open a blockage of the artery.
Cardiac stent:	A small wire mesh tube (stent) is inserted into a blocked artery to restore blood flow to the heart muscle.
Rotoblation:	Rotoblation: The use of a diamond tipped burr (Rotoblator) to cut through a blockage in an artery.
Cardioversion:	A procedure to convert irregular heart rhythms to normal rhythms through use of a well-controlled and perfectly timed electrical shock to the chest wall.
Electrophysiology Evaluation:	A study used to access the origin of cardiac rhythm disturbances. Small catheters are placed into the heart via the femoral or brachial artery and are used to test the heart’s electrical system. The patient’s abnormal heartbeat can be induced for diagnosis and treatment.
Electrophysiology Syncope Study:	A study used to diagnose the cause of fainting spells. While monitoring the EKG and blood pressure, the patient’s bed is tilted from a flat to upright position. Once the individual’s responses are documented, treatment can begin to prevent recurrent episodes.
Internal Cardioverter- Defibrillator Implant:	A small device implanted in the chest that can act as a pacemaker, or to generate a mild shock to restore normal heart rhythm when needed.
Pacemaker Implant:	A tiny device implanted in the chest to electronically prompt the heart to beat in rhythm.
Implantable Event recorder:	A tiny recorder is implanted beneath the chest wall to provide up to 14-months of monitoring for cardiac rhythm disturbances.
Catheter ablation:	Tiny groups of heart cells causing abnormal rhythm are located and mapped via a catheter placed in the heart. A signal is sent along the catheter to silence the cells causing abnormal rhythm.
Cardiac Implant Closure Device:	The percutaneous closure of a patent foramen ovale (opening between the chambers of the heart) is performed using a special closure device attached to a catheter.
Interventional Radiology
Abdominal Aortic Aneurysm Repair:	A procedure used to repair an abdominal aortic aneurysm via catheters.
Peripheral angioplasty:	A procedure using a balloon catheter placed in a peripheral artery to open a blockage of the artery.
Renal angioplasty:	A procedure using a balloon catheter placed in the renal artery to open a blockage of the artery.
Fistulogram:	A procedure used to visualize a fistula using contrast and fluoroscopic X-Ray.
Carotid angiogram:	A procedure using X-ray examination via catheter placement in the carotid arteries to check for a narrowing or blockage.
Carotid stent:	A procedure to insert a small mesh tube (stent) into the carotid artery to restore blood flow through the artery.
Central line procedure:	A procedure to place a central venous catheter using fluoroscopy.
Cerebral angiogram:	A procedure to visualize the cerebral arteries using contrast and fluoroscopy.
Dialysis catheterization:	A procedure to place a catheter to be used to exchange blood during renal dialysis.
Embolization:	A procedure to place small coils in an artery in order to occlude an artery which has been damaged or is no longer in use.

Extremity arteriogram:	A procedure to visualize the arteries of an extremity using contrast and fluoroscopy.
Gastrostomy tube placement:	A procedure to insert a tube directly into the stomach from the abdomen.
IV port insertion:	A procedure to insert an IV that is then capped off and used for intermittent medication administration.
Central line insertion:	A procedure to insert an IV catheter into one of the largest veins deep inside the body.
Filter insertion:	A procedure to insert a stainless steel umbrella (filter) into the largest vein to prevent blood clots from traveling from the leg to the lung.
Liver Biopsy:	A procedure to remove a small piece of liver tissue using X-ray to guide the needle.
Percutaneous nephrostomy:	A procedure to place a tube directly through the skin into the kidney for drainage.
Percutaneous transhepatic cholangiogram:	A procedure to visualize the liver and gallbladder using contrast and fluoroscopy.
PICC line procedure:	A procedure to insert an extra long IV catheter that will remain in over a period of time and can be used for home or intermittent medication infusions.
Pulmonary angiogram:	A procedure to visualize the pulmonary artery using contrast and fluoroscopy.
Renal angiogram:	A procedure to visualize the renal arteries using contrast and fluoroscopy.
Transjugular intrahepatic portal system shunt:	A method to divert blood from the liver using an intravenous catheter.
Venacavagram:	A procedure to visualize the vena cava using contrast and fluoroscopy.
Lower extremity venogram:	A procedure to visualize the lower extremity veins using contrast and fluoroscopy.
Renal venogram:	A procedure to visualize the renal veins using contrast and fluoroscopy.
Upper extremity venogram:	A procedure to visualize the upper extremity veins using contrast and fluoroscopy.
Visceral angiogram:	A procedure to visualize the viscera using contrast and fluoroscopy.

Cardiac Catheterization

What is Cardiac Catheterization?
Cardiac catheterization is a specialized x-ray examination that uses “live” digital images of your coronary arteries and the pumping chambers of the heart to diagnose heart disease.

How does it work?
The arteries of the heart can’t be seen with regular x-rays. To see them, a tiny plastic tube is threaded from the groin to the entrance of a coronary artery. A special x-ray dye is injected into the artery so it can be seen. High speed x-rays are taken at the same moment the dye is injected into each artery.

Why do cardiac catheterization?
To see if one or more of the arteries that supply blood to the heart is narrowed or blocked. Blocked arteries can be opened quickly, using a variety of methods. Your cardiologist can:

Use a catheter with a balloon on the tip to try to open the blockage (angioplasty).
Place a wire mesh device called a stent at the site of the blockage to help ensure increased blood flow through the artery.

What are the benefits?
A heart attack can be prevented or stopped in progress, saving the heart muscle from life-threatening damage.

Is it safe?
Complications occur in fewer than 1 in 200 cases. They include tearing of the artery wall, allergic reactions to the x-ray dye, heart attack, stroke and, in extreme cases, death. The benefits of this exam often greatly outweigh the risks.

What are the limitations?
Sometimes arteries are so severely blocked that it would not be safe to put balloons or stents into them. These patients are referred to a heart surgeon for possible heart bypass graft surgery. Cardiac catheterization can provide the surgeon with a “roadmap” of the arteries, showing the surgeon where to bypass the blocked artery.

How soon will you know the test results?
The cardiologist will know if there are any blockages in your arteries immediately after the procedure. Later in the day your cardiologist will explain the results of your test in greater detail, and discuss treatment options with you.