Heart Catheterization Procedure

My heartcath was scheduled for July 23rd. In my case, the purpose of the test was to get a better sense of the magnitude of the aortic regurgitation, the size of the aneurysm, and a look at my coronary arteries. The only reason to read this post is if you want to understand the procedure from the patient's perspective. Otherwise it's kinda boring.

Preparation
I arrived at the hospital at 2:00. By about 2:20 I was in the preparation and recovery room with the other patients. My nurse was very nice, but unfortunately, I've forgotten her name. After weighing me, I went to my bed and curtain area and changed into the gown. Meg was with me for the start, but was asked to leave while the nurse prepared me. The preparation in included a partial shave on both sides of the groin and then an IV was started in my arm. I was also connected to heart and blood pressure monitor. Meg was invited back into the curtain area to wait with me after all this was done. We watched a video about the procedure and then had a chance to ask questions. The nurses all encouraged me to get an angio-seal. Instead of a clamp, the angio-seal uses a collagen to seal the opening made in the femoral artery near the groin. They said that the bleeding stops much faster and that you may be able to go home within 2 hours. Although I was ready to go by about 3:20, they didn't take me into the procedure room until about 5:00. Before going down to the room, I was given some benadryl in the IV to relax me.

The Procedure
The room is very cold. You get even colder when sterilizing solutions is sprayed on both sides of your groin. After about another 10 minutes Dr. M was about ready to start. They asked if I wanted more general pain relief. Dr. M said I probably wouldn't need it so I declined. He then said I would feel a pop as he set up the puncture of the artery and put in the "introducer sheath" which is a tube through which the catheter can be inserted into the artery. It didn't hurt much at all. Then in just a few seconds the catheter was inserted and it was right up next to my heart. I could watch it on the giant monitor. I could not feel the catheter inside me. Then the catheter was moved into my heart. All of a sudden my heart rate went to 180 on the monitor and I could feel it in my chest. My heart was really racing. Within about 30 seconds I felt much better. The doctor said that was because the catheter was no longer inside my heart. I looked again at the monitor and could see this. Again it was moved into my heart and it started beating faster but not too fast to continue with the test. Die or "contrast agent" was injected through the end of the catheter. The die went all over the chamber, documenting the regurgitation (leak) in my aortic valve. Next I believe the doctor switched catheters, which I did not feel and took only a few seconds. Now Dr. M was trying to get die injected into my coronary arteries to check for heart disease. It took a few tries but eventually he hit it right and the screen showed my entire coronary artery filled with die. This was good news meaning no blockage or any sign of heart disease.

Angio-Seal (AS)
As advised by the nurses, I asked for the AS. Another nurse came in to do the sealing procedure. After being essentially painless since the original puncture, this actually hurt a lot and I began to raise my leg at the knee. They told me to lie flat or they would not be able to do the seal. I got through it, but now regretted my earlier choice to skip the additional pain relief. I was then wheeled out of the procedure room, about a half hour after being wheeled in.

Recovery
For the first hour they ask that you lie very still and not move your legs. In the recovery area I was back in my original curtain area and Meg was with me. Everything went fine for the first hour. The nurse checked my bandage for bleeding and there was none, just some tenderness. I was given a little morphine via IV. After an hour they propped me up in bed and I had something to eat and drink. After that I was asked to get out of bed slowly and walk 30 feet and sit back down. If you can do that three times about 15 minutes apart without having your heart rate crash or faint you can be discharged. I felt a little wobbly getting back into bed and within a few minutes my heart monitor alarm went off, my blood pressure dropped to 80 over 40 and my heart rate dropped below 50. They leaned me all the way back to flat in the bed and slowly I started to feel a little better. In the meantime, a lot more people came into my area because of the alarm. The staff talked to me and said a lot of the young guys faint. I love being called young! The nurses all encouraged me to drink more and urinate. I did all this but it wasn't easy if you know what I mean. Later I tried another walk. Meg thought I looked terrible again after that 30 foot walk. My heart did not decelerate, but I did need to lie back down again. At this point it was moving on toward 9:30 and the heart cath area was closing. My very kind nurses had already stayed past the end of their shift. They arranged for me to be admitted to the hospital for a few more hours of observation.

I ended up with a private room upstairs around 10:00. After about 45 minutes on the 4th floor I started to feel a little better. I made a 25 foot walk and came back to bed feeling okay. Just two more walks and I could go home. By about 11:30 I had completed my walks and was discharged just before midnight.

Recovery at Home
The next day you are tender in the groin area and need to take it easy. No driving that day and I stayed home from work. The next day was Saturday and I was feeling much better, able to walk with no pain, just an awareness of tenderness in the groin area. The bandage came off and it looked fine with no bleeding.

The next day was Sunday and I began a college visiting trip to Southern California with my daughter. We shared the driving and the trip went fine.

My only advice to other patients is to accept more pain relief at the beginning of the procedure, especially if you get the angio-seal.