In preparation for next month’s aortic valve replacement, I have to go in Friday to have my heart catheterized. I’ve read up on it and understand the procedure, but am a little uneasy about having something run up through a blood vessel into my heart. I’m kind of nervous about the wire itself interfering with my heart’s functioning, especially when it goes through a valve. (My aortic valve is only about 1 square cm now.)
So what should I expect, from the patient’s point of view? Will I be able to feel it, as it passes through my heart? And what about afterward, in recovery? I understand that I’ll be conscious during the procedure, but they’ll give me something to help me relax. Is that what I’ll be “recovering” from, or will I be recovering from the actual procedure? How soon will I “be myself” again? How soon until I’ll be able to sit up? Eat? Go home?
If I’m feeling nervous about the catheterization, wait till I have my valve replacement.
Frankly the valve replacement is going to be much worse than the cardiac Cath. There is the risk of puncturing through a blood vessel or heart muscle during the Cath, but that is pretty rare. Bleeding is a more common side effect. But they put a compression device over the femoral artery in the groin where they go in prevent bleeding. You will have to lay flat for a number of hours after the procedure. Be prepared to have to use a bed pan if you need to use the bathroom. They are deadly serious about keeping the leg straight no matter what. Once you are allowed to get out of bed, you should be good to go home soon after that.
I had a cerebral angiogram. Same general idea but the wire went a bit further. I was awake and alert through the whole thing.
Prep involved shaving a spot high on the inner thigh. They put in an IV but it was a “just in case” as I recall. Maybe there was some meds to relax me, but I don’t recall that.
Once in the procedure room they applied a topical antiseptic and gave a little shot of lidocaine or other numbing agent. Then made the cut in my leg to insert the wire. I didn’t feel it.
I never felt the wire moving around. Not as it went up, not as it went through my heart. My procedure did invovle injection of an iodine dye to check out the arteries in my brain. I did have a weird taste sensation when that was injected. The doctor warned in advance just before he did that so it was no surprise.
Throughout the procedure I was talking to the radiologist and could tip my head and see the screen with the image of where the wire was. The doctor did check out my coronary arteries (same iodine dye injection) so long as we were already there. I did not feel anything as that happened.
In recovery they told me I had to lie flat on my back for several (4 to 6, don’t recall exactly) hours. This was to ensure the puncture into the femoral artery was not stressed and closed appropriately. No rolling onto my side. No propping up and watching tv. BORING. I counted the tiny holes in the acoustic ceiling tiles to pass the time. It was just a few hours and I could have slept but didn’t. Recovery was the worst part of it for me.
And after that I just got up and walked out of the hospital. I felt fine immediately. I did have a family member drive me home. Doctor said no strenuous exercise for a couple days after which I took as permission to sit in the recliner in front of the tv.
As far as I can figure, the reason your doc wants to do a heart cath before your valve replacement is to check on the status of your coronary arteries. Sometimes people have some nasty surprises in there when they first get looked at, and it’s nice to know whether or not a person could really use a couple of bypass grafts before they open your chest up to do something else. It could be done all at once, see?
Most likely, though, unless you’ve had symptoms this is really just a look-see. Most of my patients get Versed for their procedure, which is the same drug that’s used in a lot of colonoscopy-type things. It chills you out a little; there’s certainly a continuum of responses but most people aren’t ever fully knocked out. Then again–some are. Just depends. Either way you shouldn’t be uncomfortable during the procedure.
You won’t feel the wire as it’s advancing but you may have a flushing sensation when the dye is injected. Your heart shouldn’t experience any malfunctioning from the wire, even when it’s going through the valve.
The toughest part of the heart cath is usually the recovery period. Depending on what they find, they may use a vascular closure device that only requires a couple hours of bedrest and then you’re good to go. If they find anything that requires an intervention (angioplasty, stent), however, that will likely necessitate a bit longer of a stay with the big tube that they put the wire through (we call it a sheath). Again, depends on what gets done, but the amount of time that it takes before that comes out varies, and the clock on your 4-6 hours of straight-legged bedrest starts once it’s out and you’re not bleeding.
HOWEVER–that’s all assuming they find something. Like I said, it sounds like your procedure is a “just in case, let’s check things out before we get in there” kind of check. If it shows nothing interesting, you could be on your feet and out the door within 3 hours.
My experience was a little different from Rhaegar’s. I only had to lay flat for 30-45 minutes afterward (having to be immobile for a period of time was one of my fears going in). They used a “star suture” to seal me up; I really don’t know if that has anything to do with the different recovery times. Once that 30-45 minutes was up, I went home. I definitely remember some soreness/stiffness for a week (maybe a few weeks) afterwards, but not intolerably so.
As best as I can remember, the actual procedure was 30-45 minutes, as well. I couldn’t feel a thing inside me. I don’t remember them giving me any drugs to help me relax; they played music during the procedure which was helpful for me.
They even had a screen where I could watch what was being revealed inside of me. I didn’t watch it the whole time, but it was interesting to glance at from time to time. You could see the dye branching out into all the vessels, making them visible to the camera. Made me think of an octopus, in an ink/camouflage kind of way.
I had one a couple of years ago, and my husband has had a couple. For both of us the cath was completely painless and uneventful. I don’t remember a thing about it, but the recovery was boring. I am not good at lying still, and you have to. My biggest problem was getting my usually low anyway blood pressure to come up enough so they would release me.
I had one done previous to having a CABG a few days afterwards.
The whole experience was OK; waking up after the surgery was worse.
I wasn’t sedated at all. The room was freezing, but they gave me a blanket that was fresh from the blanket warming machine. The lidocaine stung just like they said it would. I found the pressure on my leg uncomfortable while they were feeding the wire in.
I was able to see some of the images of my heart, which I found distracted me from everything else going on around me.
I’ve had angioplasty with stent(*) and, years later, an angiogram. I might have noticed a slight brief tickling sensation in my heart(!) but that may have been psychological. Shaving the pelvic hair could have been exciting, but my wife was there so hospital took the precaution of using one of the older less attractive nurses for that. :dubious:
Afterword they kept my leg in a tight vice for several hours the first time, but not the second. (I don’t know if the difference was insertion-vs-just-imaging, or due to a procedural improvement.) Hardest part was urinating; I’d never done that horizontally before. Finally I got my wife to lock the door and then managed to fill a one-liter container to the very brim.
About ten years ago, the complete cost of the balloon/stent procedure was $8500, most of which was for the top-of-the-line “coated” stent itself. The angiogram was $1000. These procedures were done at one of Bangkok’s finest private hospitals. I’m curious what the costs would have been in U.S.A.
(* - The morning before I got the stent I couldn’t walk more than a few yards without severe angina. Years earlier I’d had a moderate heart attack and, to answer a question from a previous thread, it was painful, remaining too painful for me to sleep for several hours.)
The test itself was nothing, but the recovery lasted 6 hours. My knee and back still hurt from the experience.
What the test revealed is that, in addition to my aortic valve replacement, I’ll also need triple or quadruple bypass surgery, done at the same time. The surgery is scheduled for August 20, and I’ll be in the OR for 5-6 hours.
Well I see I’ve come to the party late. But anyway, my experience was:
For me, my procedure was to do with heart rhythm so a machine sped up and slowed my heart as they did tests – now that was weird.
But more relevant to the OP, I didn’t feel the initial insertion nor the wires moving through the body.
Removing the wires was not too pleasant as they have to press on the area to prevent bleeding. In my case they used a belt and plastic ball to apply very strong sustained pressure.
And obviously the area was tender for some weeks after.
But really it wasn’t particularly painful and didn’t stop me doing much in the days immediately following.
Shaving the pelvic hair could have been exciting, but my wife was there so hospital took the precaution of using one of the older less attractive nurses for that. :dubious: