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Cath (catheterization) Lab

Cardiologists perform interventional radiology and a number of special procedures by means of 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.​​​​​​

Patients with totally blocked coronary arteries like Ike Topliss are benefitting from new procedures in the Cath Lab

Cardiac Cath Lab Procedures

Inpatient Procedures

  • 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.
  • Cardiac Stent: A small wire mesh tube (stent) is inserted into a blocked artery to restore blood flow to the heart muscle.
  • 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.
  • 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.
  • 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.
  • 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 can 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.
  • Percutaneous Transluminal Catheter Angioplasty: The use of a balloon catheter placed in the coronary artery to open a blockage of the artery.
  • Rotoblation: The use of a diamond tipped burr (Rotoblator) to cut through a blockage in an artery.

Outpatient Procedures

More experience, better outcomes for patients

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. The arteries of the heart can’t be seen with regular x-rays, so the traditional procedure was to thread a tiny plastic tube from the groin to the entrance of a coronary artery. This was uncomfortable for patients who remained confined to a gurney for several hours and were required to stay overnight at the hospital.

Now, the preferred approach is to thread the catheter from the radial artery in the wrist. This not only greatly increases the comfort level for patients, but it also reduces the possible complications from the procedure. Patients' length of stay is often as short as two to three hours. This means that overall cost of care is reduced because an overnight stay is avoided.

The cardiologists at the Oregon Heart & Vascular Institute have more than a decade of experience performing thousands of radial access procedures for cardiac patients. In the past five years alone, they have completed 2,644 procedures with no serious complications and excellent outcomes. The heart care specialists at OHVI perform nearly 3,000 catheter-based cardiac procedures each year.
Procedures offered via radial access include diagnostic angiographyangioplasty and stenting.

Interventional Radiology Procedures
  • Abdominal Aortic Aneurysm Repair: A procedure used to repair an abdominal aortic aneurysm via catheters.
  • Angiogram (Carotid): A procedure using x-ray examination via catheter placement in the carotid arteries to check for a narrowing or blockage.
  • Angiogram (Cerebral): A procedure to visualize the cerebral arteries using contrast and fluoroscopy.
  • Angiogram (Pulmonary): A procedure to visualize the pulmonary artery using contrast and fluoroscopy.
  • Angiogram (Renal): A procedure to visualize the renal arteries using contrast and fluoroscopy.
  • Angioplasty (Peripheral): A procedure using a balloon catheter placed in a peripheral artery to open a blockage of the artery.
  • Angioplasty (Renal): A procedure using a balloon catheter placed in the renal artery to open a blockage of the artery.
  • Angiogram (Visceral): A procedure to visualize the viscera using contrast and fluoroscopy.
  • 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 catheter into one of the largest veins deep inside the body using 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.
  • 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.
  • Fistulogram: A procedure used to visualize a fistula using contrast and fluoroscopic x-ray.
  • 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.
  • 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.
  • 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.
  • Venogram (Lower Extremity): A procedure to visualize the lower extremity veins using contrast and fluoroscopy.
  • Venogram (Renal): A procedure to visualize the renal veins using contrast and fluoroscopy.
  • Venogram (Upper Extremity): A procedure to visualize the upper extremity veins using contrast and fluoroscopy.
​Chronic Total Occlusion Intervention

Chronic total occlusion (CTO) is a complete blockage of a coronary artery that has been in place for 30 days or longer. CTOs are very common, occurring in 15 to 20 percent of patients with significant coronary artery disease. The condition can cause severe angina (chest pain) and lead to a lower quality of life.

Most CTO patients are treated with medical therapy or bypass surgery. However, interventional cardiologists at Sacred Heart Medical Center offer a minimally invasive procedure that can reroute blood flow around the blockage and restore selected patients' quality of life.

Hybrid CTO Approach

Through a small incision in the femoral artery near the groin, our interventional cardiologists use a catheter to gain access to the blockage and reroute the blood flow around it. Thanks to advances in technology and technique, our team of experts can approach blockages from either the front or back, via collateral vessels that develop over time. This "hybrid" approach provides more treatment options and improved patient outcomes, with more than 95 percent of blockages successfully treated in our cardiac catheterization lab.

Patient Benefits

Patients with successful interventions typically experience immediate and dramatic symptom relief.