Cardiac catheterization in Düsseldorf and Germany: Important information from your cardiologist Dr. Bruno

Cardiac catheterization is a crucial examination in modern cardiology, which is used both for precise diagnostics and for the direct treatment of heart disease. At our cardiology practice Kardio Pro in Düsseldorf, we provide comprehensive advice on this procedure. Dr. Raphael Bruno uses the latest non-invasive diagnostics to clarify whether a Cardiac catheter-examination is necessary and sensible for you. We accompany you throughout the entire process: from careful preparation and organization of the examination in a specialist clinic in Düsseldorf to the essential follow-up care in our practice.

Cardiac catheterization: What is it and when is it necessary?

One Cardiac catheterCoronary angiography is a minimally invasive, X-ray-assisted procedure. A very thin, flexible plastic tube (the catheter) is inserted through an artery - usually in the wrist (radial artery) or, more rarely, in the groin (femoral artery) - and advanced to the heart. The doctor can inject contrast medium directly into the coronary arteries via this catheter. The X-ray images then make the blood flow visible and show constrictions (stenoses) or occlusions with the utmost precision.

The decision for a Cardiac catheter-The decision to perform a CT scan (CT => stress test ==> coronary) is made by your cardiologist Dr. Raphael Bruno after careful consideration and on the basis of previous examinations. The most common reasons (indications) for this procedure are

• Suspected coronary heart disease (CHD): If non-invasive tests such as an exercise ECG or a stress echocardiogram indicate relevant circulatory disorders of the heart.
• Acute myocardial infarction: Here is the Cardiac catheter is the method of choice to reopen the blocked coronary artery as quickly as possible.
• Clarification of heart valve defects: To accurately assess the severity of a narrowed or leaking heart valve before a possible operation or valve replacement.

In our practice in Düsseldorf, we create the basis for a targeted and safe performance of the cardiac catheter through comprehensive pre-diagnostics.

Our role as your cardiology practice before and after cardiac catheterization

It is important to understand that the Cardiac catheter-examination itself is carried out in specialized cardiology centers or hospitals. However, as your outpatient cardiology practice Kardio Pro, we are your central and constant point of contact who manages and accompanies the entire process.

Our services before the procedure:

• Indication: We carry out all the necessary preliminary examinations and determine whether a Cardiac catheter is the right measure for you.
• Clarification: Dr. Raphael Bruno will explain the procedure, the goals and the possible risks of the operation to you in a detailed personal consultation.
• Organization: We work closely with leading clinics in Düsseldorf and organize the appointment for the examination for you.
• Preparation: We will arrange all the necessary preparations such as blood tests (kidney values, blood count, coagulation) and give you precise instructions, e.g. on taking medication.

Our services after the procedure:

• Aftercare: Immediately after you are discharged from hospital, we will take over your further treatment. We will check the puncture site and discuss the results of the cardiac catheter with you in detail.
• Therapy adaptation: We optimize your drug therapy based on the results. In particular, the correct intake of blood-thinning medication after stent implantation is crucial and is closely monitored by us.
• Long-term care: We work with you to develop a long-term concept for secondary prevention that includes lifestyle changes and regular check-ups.

So you are never alone at any time. We are your guide and medical partner before, during and after the Cardiac catheter.

Cardiac catheterization: The typical course of the procedure

Although the examination takes place in hospital, it is important to us that you know exactly what to expect. The fear of the unknown can be reduced by providing transparent information.

One Cardiac catheter-The examination usually proceeds as follows:

1. Preparation: You will be given a local anesthetic at the planned injection site (wrist or groin). You will be awake and responsive during the entire examination. General anesthesia is not necessary; a mild sedative can be administered if necessary.
2. Insertion of the catheter: The doctor inserts a thin sheath into the artery, through which the catheter is then advanced painlessly to the heart.
3. Contrast medium injection and images: Contrast medium is injected into the coronary arteries under X-ray control. You may experience a brief, intense feeling of warmth in your body, which is normal and harmless. During the procedure, X-ray films (angiographies) are taken.
4. Pressure measurement: In addition, pressure measurements can be taken in the heart chambers to assess the pumping function.
5. Possible intervention: If the doctor detects a high-grade narrowing, the examination can often lead directly to treatment (see next section).
6. Conclusion: After the examination, the catheter is removed and the puncture site is treated with a pressure bandage.

The pure diagnostic examination usually only takes 20 to 30 minutes.

Diagnostic vs. therapeutic cardiac catheterization: A comparison

The Cardiac catheter is not only used for pure imaging, but also enables the direct treatment of constrictions during the same procedure. A distinction is therefore made between diagnostic and therapeutic (interventional) procedures.

With the Balloon dilatation (PTCA) a small balloon is placed at the tip of the catheter in the constriction and inflated to widen the vessel. In order to keep the vessel permanently open, a Stent - a small tube made of metal mesh - is implanted. These interventions are now routine and have revolutionized the treatment of CHD.

Frequently asked questions about cardiac catheterization

Here we answer common questions that patients at the Kardio Pro practice ask us about cardiac catheterization.

Do you perform cardiac catheterization in your practice?

No, this clarification is very important to us. As an outpatient specialist practice, we carry out Cardiac catheter-examination yourself. We determine the medical necessity, prepare you optimally and take over the complete aftercare. The procedure itself takes place in a specialized department of a cooperating hospital in Düsseldorf and we not only work together with the university hospital, but are also networked with the Augusta and EVK.

Is a cardiac catheterization painful?

The examination itself is not painful. You will be given a local anesthetic at the puncture site so that you only feel a small prick from the puncture. The advancement of the catheter inside the vessels is not noticeable as the inner walls of the vessels have no pain nerves. Only the administration of the contrast medium can cause a brief, intense feeling of warmth.

How long does the hospital stay last?

In the case of a purely diagnostic Cardiac catheter-After the intervention via the wrist and without complications, patients can often leave the clinic on the same day or the morning after. If an intervention with stent implantation has been performed, the stay is usually one to two nights for monitoring. In the case of a heart attack, the stay is correspondingly longer.

What do I have to consider after a cardiac catheterization with a stent?

Aftercare is crucial for long-term success. The most important thing is to consistently take the prescribed blood-thinning medication (usually two different preparations for several months) to prevent the formation of blood clots in the stent. In addition, regular check-ups at our practice and a heart-healthy lifestyle are essential.

What are the risks of a cardiac catheterization?

Although the Cardiac catheter is a routine procedure today, it is an invasive procedure with potential risks. The most common, mostly harmless complications include bruising at the puncture site. Rarer risks include secondary bleeding, allergic reactions to the contrast medium, cardiac arrhythmia or damage to the kidneys. You will be informed about all risks in detail.

Will I be fully resilient again after the examination?

After a purely diagnostic examination, you should rest for a few days, especially the arm or groin where the puncture was made. After a stent implantation, the duration of rest depends on the individual findings, but a gradual return to normal activity is usually possible and desirable after about a week. You will receive the exact recommendations from us.

Why is the wrist usually chosen as the access route today?

The approach via the wrist artery (radial approach) has proven to be the most suitable for the Cardiac catheter has become the standard in many cases. The advantage is a significantly lower risk of bleeding compared to access via the groin. In addition, patients can get up again more quickly after the procedure and are less restricted in their mobility.

What is a drug-eluting stent?

Modern stents are usually coated with a drug (drug-eluting stent, DES). This drug is slowly released into the vessel wall over several weeks and inhibits cell growth there. This significantly reduces the risk of re-narrowing within the stent (in-stent restenosis).

Do I have to take medication for the rest of my life after a cardiac catheterization?

In most patients with coronary heart disease who are treated with Cardiac catheter has been diagnosed, lifelong drug therapy is necessary. This usually includes an antiplatelet agent (such as ASA), a cholesterol-lowering drug (statin) and often medication to control blood pressure. This therapy protects you from the progression of the disease and future events.

Does cardiac catheterization replace other cardiological examinations?

No, the Cardiac catheter is not a substitute, but a supplement and often the conclusion of a diagnostic chain. Examinations such as the stress ECG, cardiac ultrasound or the long-term ECG are and remain the fundamental tools in our practice. They help us to make the right decision as to whether an invasive procedure such as cardiac catheterization is necessary at all.

Comprehensive care: Your care around the cardiac catheter

An upcoming Cardiac catheter-It's understandable that a medical examination can cause worry. At the Kardio Pro practice in Düsseldorf, we want to take these worries away from you by providing seamless and personal care. Dr. Raphael Bruno and his team are your permanent contacts who will guide you through the entire process - with the highest level of medical expertise and human care. Make an appointment to discuss all your questions at your leisure.