Basics

Cardiac catherization of the coronary arteries is always recommended when there is a sound assumption that the blood flow in the arteries is impaired and leads to a reduced blood supply of the heart muscle.

For this purpose, I usually puncture the right or left radial artery [see below] and introduce a small canule with a diameter of around 2mm in the artery. Then, contrast media are injected into the arteries to visualize them radiologically [“Cine-Angiography”]. The vessels shown on cine-angiography are then assessed for further proceeding.

Consequences after a diagnostic coronary angiography

The assessment of the coronary arteries always has three possible conseuqences:

1. The coronary arteries do not have any functional effective narrowings >> then no further interventional nor surgical consequences need discussion.
2. If there are few narrowings which can be dilated immediately >> then, this will be performed within the same session.The a small balloon is introduced into the lesion of the artery and blown up until the lesion does not impede the blood flow any more.To secure the result of the balloon dilatation, normally a stent is placed into the lesion site.
3. If the coronaries are diseased on many sites and the amount of coronary arteriosclerosis is diffuse and complex, no immediate intervention wil follow. In this case, the patient will be taken from the catheterization rable and the result will be discussed with him and his relatives and also with a cardiac surgeon – to find the best solution for the patient.This might be a complex catheter intervention or bypass surgery.

Possible textbooks:
Dr. Georg Gaul: Herzinfarkt, Verlag Holzhausen, 2008 [in German]