Angiogram in stead of cardiac cath

[mikeb85]

Hi all
Have any members had any experience with this? I recently heard that the Angiogram (Chest CT with contrast dye) can show any clogged arteries and allow measurements that the cardiac cath is able to. I am very interested in keeping the holes that will be put in my flesh to a minimum! I Know I need the Aortic valve replaced (severe stenosis)and wonder exactly what need there is for an additional leg wound to recover from. I am also expecting some ascending aorta repair(dialated to 5cm) and question the need for a wire being snaked thru my aorta. I kinda wonder if this cath is sometimes done just to extract the extra $$$ from the insurance companies. I would certainly like to hear the opinions of our more experienced members.

mikeb

 

[Lynlw]

There was a thread about this yesterday http://www.valvereplacement.com/forums/showthread.php?t=29316

 

[bookjp]

Hey Mike,I was in your position also .Had the ct scan but my surgeon also ordered the heart cath.I was hoping I wouldn't need heart cath same as you but understand its pretty common to have both.Sounds like we're both in about the same position with the ascending aorta.Mines 5.0-5.3 cm.also I might be looking at some arch work.I'm not going back till it's time for surgery. Everytime I see my surgeon something else seems to come up!!!!!!

 

[ALCapshaw2]

Most surgeons like to see the results from a Cardiac Cath to check for clogged arteries and measure pressure gradients across the valves. They also want a Right Heart Cath to know the condition of your Pulmonary artery and Lung function. It wouldn't hurt to ask the Cardiologist to be 'gentle' when going through the area of your aortic aneurism.

I'm thinking that 'some' (few) surgeons have proceeded with Young Female patients based solely on a Chest CT with NO symptoms.

Bottom Line: Ask your Surgeon what HE wants and why.

'AL Capshaw' (many cath's 'under my belt')

 

[DebbyA]

This is from the Guidelines for management of Valvular Patients from the Reference Sources forum:
In general, because angina is a poor marker of CAD in patients with AS, coronary angiography is recommended in symptomatic patients before AVR in men older than 35 years; premenopausal women older than 35 years with coronary risk factors, as well as asymptomatic men older than 45 years; women older than 55 years; and those with 2 or more coronary risk factors.

Any of these fit you?

 

[mikeb85]

reply to debs post

reply to debs post

I have already had the coronary angiogram and If that shows the condition of the coronary arteries why would I want to endure yet another invasive procedure (cardiac cath) What is the real benifit? I am going to have AVR anyway. One less wound to recover from

mikeb

 

[mikeb85]

Correction/clarification

Correction/clarification

Hi All,
I just wanted to let all that were interested know that I had mistakingly assumed that I'd had a proper CT scan of my heart. What I had actually had a chest CT with contrast, as it turns out they can do a CT scan of the heart specifically and would likely be able to identify any blockage in the coronary arteries. I asked for this procedure instead if the usual Cath and my request was granted without any hassle. I had done some research and found that a study was done in 2006 which involved almost 300 people who were about to have a cath procedure and agreed to a cardiac CT to determine if the results would be the same. The CT was done with a 64 slice unit and yeilded the same result as the cath in 92% of the patients! The hospital I am dealing with has a 320 slice unit and I am confident that the imaging will be even better than the 64 slice and able to detect any blockages. The cost comparison of the two procedures is substantial, CT is about 1/2 the cost of Cath. I can understand the use of Cath when the hospital does not have the better CT equipment but wonder how often profitability issues drive the choice. I felt, personally, that one less invasive procedure would minimize my overall risk and was pleased that my request was granted. I realize that thousands of cath proceedures are done weekly but with the risks of heart attach and stroke being associated with the cath it didnt give me any warm fuzzy feelings about having one done on me.

Mikeb

 

[luvsgod]

Mike,
I am having my second AVR next week and my surgeon insisted I have a heart cath to check for blockages. I had my cath Friday 13. I traveled round trip 5 hrs., stayed 2 nights in a hotel near facility (UAB,AL) had to lie still in bed for 6 hours and my arteries were fine. (I loath staying in bed!) I had a cath 15 months ago prior to my 1st AVR and I had no blockages. Maybe it has something to do with liability for the 8% the CT doesn't identify.

 

[mikeb85]

Luvs,
Sorry to hear you need another surgery. I didnt even discuss the the cath/ct issue with my surgeon. I had heard that the CT was used instead from another forum member and asked the surgeons assistant about the option during the pre surgery seminar. I was probably somewhat assertive in my tone regarding the avoidance of invasive procedures. but they were happy to oblige my request , thankfully The worst thing about this whole valve replacement thing the no garrantee part, Good luck with your surgert
mike

 

[JaneBerm]

Happy CT person vs. Cath

Happy CT person vs. Cath

Hi Folks,

I'm a very happy CT Angiogram vs. cardiac cath VR candidate! My cardiologist originally was ready to schedule me for the cath and when I objected and sugested that a CT Scan might be substituted instead, he actually listened and brought that idea to the surgeon. Together, they decided that they would try the scan first and only if they weren't able to get good pictures of the arteries would they back it up with a cath. LIke Mike, my hospital has great equipment and they werre able to get the info that was needed to forego the cath. I'm with Mike in realizing that there are a lot of MDs out there who are making some big bucks on caths, when if the proper equipment is available the scan will give the info at half the cost and many more times less the discomfort of the patient!

I'm anxious to hear from other members regarding this issue as more of us begin to follow this route on our way to surgery.

Jane