coronary angiogram

[ChouDoufu]

i'm wondering about the hazards of having a heart catheter performed.

i've read that the angiogram is used to confirm echo readings and to
check for arterial blockage/disease, and is often done the day before
surgery. so maybe not absolutely essential (given the circumstances)
this far in advance?

planning on avr in january, surgeon in india wants me to have angiogram
done soon, but i'm a bit worried about chinese doctors. i'm going to the
big city of nanning (pop 4 mill, 3 hours by train) where i've located one of
the top 100 hospitals in china, with what seems to be a decent cardio
department. i'm comfortable with them doing tee/tte, but angiogram?
definitely not comfortable with them doing something invasive.

what's the change of injury or damage to arteries or heart dangly bits?
if absolutely essential, i could go to kunming (9 hours by train) where
there is a canadian-chinese joint venture hospital.

 

[Duff Man]

My uncle had an angiogram done specifically for the coronaries and they nicked his coronary artery and they had to do emergency bypass surgery because the torn inner endothelial flap was basically causing ischemia by shunting off blood flow.

I don't have statistics, but it happens. I think you're better off with a hospital that's done alot of them. I also believe that statistics you might find in studies don't necessarily apply to each hospital... in other words, your hospital might be better or worse than the study's hospital. I was nervous about the same thing when I thought surgery was imminent and I think I remember people saying it was less than 1% that had a serious problem.

 

[ChouDoufu]

guess i'll just go to the hospital and scope out the facilities first, have a chat with the
cardiologists, and see about having a TT-echo done. that shouldn't hurt too much.
will probably wait until i get to the heart centre in new delhi for the angiogram.

first task: find a medical dictionary.

(note: coronary angiogram in chinese is "guanzhuangdongmai xueguanzaoyingshu")

 

[Freddie]

Just as long you can pronounce it CD thats all that matters

I had my angiogram done in the wrist and it was pain free, during and after the procedure. I could walk with no limitations. I was only told to try not to use the wrist for the next couple of days. I'm right handed and guess where they did the procedure - I still had no problems.

 

[RobNDenver]

Chou,

My angiogram was performed about two weeks before surgery, to quantify the results of the surface echocardiogram. My cardiologist said that if he had found only one blockage, he would stent that one, but I still would need to have AVR since that was at the root of the problems I was experiencing. I think, no expert, that you can have the angio some time before the surgery, but they will want you to have a CT angio right before the procedure so that the Doctor can review the films immediately before operating on you. Naturally, the day before, you will get a battery of blood tests including an arterial blood gas which is not fun, but necessary right before you go under the knife. They will also establish your lung capacity with an incentive spirometer that you'll use to keep your lungs clear post op. The Respiratory Tech I worked with suggested that not inhale like a hero since that will be the measure I will be working against during recovery. He didn't want me to sandbag the measurement, but leave myself a few hundred cc's so I blue a 3500 and he was satisfied. It took me three days to get back to that number once, and five days to hit it consistently.

Talk about language difficulties. . . they call bypass surgeries here "cabbage"

Good luck to you.

 

[Jkm7]

My angio was done several weeks prior to my surgery by a fabulous interventional cardiologist. I would not submit to one being done by anyone of even average skills. Go to the best cardio center you possibly can.

If you are having it done months prior to expected surgery, there is some chance a surgeon could require a second. Are you convinced that it is really needed now seeing as your surgery is not soon?

Don't minimize a TEE. Done inexpertly, people have had less than ideal results. We have heard of permanent hoarseness etc

These tests are excellent, necessary and give very useful info but the skill and experience of the doctor is critical IMO

Good luck and please let us know how things go for you.


This is, of course, just my opinion.

 

[kschroed]

If it were me, I'd take the ride to the Canadian-Chinese facility. The procedure itself is considered pretty safe, but I would rather be in an environment where I felt comfortable. For me that would definitely be a facility with a supply of Canadian, English-speaking staff.

Kay

 

[ChouDoufu]

the management is canadian, the doctors mostly chinese. it's set up for the
ex-pat community in kunming, so upon arrival you're greeted by your very own
english speaking "personal shopper" who helps you with all the forms and escorts
you to whichever offices/clinics are on order. very high standards, and very
expensive (relatively). all brand new, the rooms have real furniture, private baths,
furnished like a five-star hotel. i'm now waiting on their email response.

plus, it's close to shopping, so i can stock up on all the things unavailable here....like
cheese, butter, coffee, deodorant, dvd's.....better still, it's across the street from
the new pizza hut. mmm, i miss pizza without corn and bamboo and fruit cocktail.

 

[ALCapshaw2]

Years ago I saw a notice to the effect that the 'event rate' for a Cath / Angiogram at my Local Hospital was 1 in 1000. They have around 6 Cardio's who specialize in Cath's and are arguably the Best Cath Lab in my state.

Be sure to clarify if your Surgeon wants a Right Heart Cath (to check your Lung Function) in addition to the usual Left Heart Cath.

Bottom Line: The More They Do, the Better They Are.

VR.com has had MANY threads / posts on Heart Cath's and Angiograms. Do a 'SEARCH' to find the links.

 

[westie]

pre op tests

pre op tests

Chou,

Naturally, the day before, you will get a battery of blood tests including an arterial blood gas which is not fun, but necessary right before you go under the knife. They will also establish your lung capacity with an incentive spirometer that you'll use to keep your lungs clear post op.

it seems there is some variance in pre op tests. for my mitral valve replacement i had a cath/anigiogram one week earlier and a blood test 3 days before the operation to confirm blood type; thats all.

no battery of tests the day before and certainly never a "arterial blood gas test" and i never came near a "spirometer" either.

and i hasten to add that new zealand has a world class first world medical system.

sorry for being the perpetual cynic, but could the "battery of tests" ,we do not seem to need in nz, have anything to do with increasing profit?

 

[ponygirlmom]

In my opinion it is far, far better to get your angiogram at least a week before surgery.

Remember that after an angiogram that is done through your groin you can be sore, and you are told not to strain the area for several days, even if you have a plug in place to prevent bleeding.

After open-heart surgery, you cannot use your arms and chest to move yourself around. How do you do it? With your legs! My heart always goes out to people who have angiograms just before OHS. It's just one more difficultly after surgery!

About reasons a doctor might want to do an angiogram weeks or months before surgery: my surgeon used the data to decide which valve I should have. (Among other things, I assume!)

 

[Bina]

Thankfully, my surgeon also specified that the angio be done at least 10 days before surgery.
They discovered my aortic root was dialating and he said that he could deal with it once I was on the table.

 

[Jkm7]

it seems there is some variance in pre op tests. for my mitral valve replacement i had a cath/anigiogram one week earlier and a blood test 3 days before the operation to confirm blood type; thats all.

no battery of tests the day before and certainly never a "arterial blood gas test" and i never came near a "spirometer" either.

and i hasten to add that new zealand has a world class first world medical system.

sorry for being the perpetual cynic, but could the "battery of tests" ,we do not seem to need in nz, have anything to do with increasing profit?

In an effort to relieve your self-suggested cynism, I thought I'd add that I had TEE about a month pre-surgery, a chest x-ray, blood and urine tests before my angio which was three weeks pre-op. The day before my surgery, I had usual blood (no arterial blood gas test ever), chest x-ray, urine and never saw a spirometer until post op. So, seems NZ and Mass General (one of America's best cardiac centers) have pre and post op testing quite similar.

 

[westie]

not these either

not these either

In an effort to relieve your self-suggested cynism, I thought I'd add that I had TEE about a month pre-surgery, a chest x-ray, blood and urine tests before my angio which was three weeks pre-op. The day before my surgery, I had usual blood (no arterial blood gas test ever), chest x-ray, urine and never saw a spirometer until post op. So, seems NZ and Mass General (one of America's best cardiac centers) have pre and post op testing quite similar.

actually, i never had either a TEE or a urine test, the cardiolgist said too many tests would make me paranoid

i never even saw a spirometer, the closest i ever got was when the nurses told me to stop talking for 2 minutes and breathe deeply....

 

[Jkm7]

Westie:

My cardio thinks the same as yours (thankfully) but in my case there was very good reason for wanting (needing) the TEE. It did provide necessary info.
Perhaps some of the difference could be that this was my second OHS and I have other heart issues in addtion to 'just' the valve.

 

[westie]

hi Jkm7

that explains it, i had no other health issues, was on zero medication and it was my first surgery.

 

[Bridgette]

I did not have a cardiac catheterisation/angio before my surgery (in NZ) as protocol here is that if under 45 with no other health issues then it is not done routinely.
I had echocardiogram, ECG, TOE (TEE) chest x-ray, blood tests, all (except for blood tests and x-ray) completed at least a week prior to surgery.
ECG's are done all the time anyway while you are an inpatient - it seems like the nurses are forever wheeling the machine in

Bridgette

 

[yankeeman]

I have two suggestions.
First, and I think someone else mentioned this, try to make sure that you have the injection site plugged...there is a specific device that makes stopping the bleeding much easier. The alternative I'm told is hours of pressure on the site.

Second, be careful how much you drink before the procedure. I wasn't and had serious problems urinating afterward. (It later turned out I had a prostate problem that worsened when I had the aortic valve replacement, but that's another story.)

I had no problem in my catheterization and it was cool to look up and see the cardiac arteries bouncing away...

Good luck.

 

[ChouDoufu]

allrighty, got in touch with the cardio department at nanning first affiliated hospital.
yes, they can do the heart cath, but they consider it an operation, not a test...and
requires three days in hospital. apparently a bunch of prep, then the test, and you
can leave sometime on the third day. scary, i think i'll wait until pre-surgery in india.

so on a whim, tried the local in-town first peoples' hospital to see about an echo.
(our little town has two hospitals, this is the one WITH stethoscopes in the emg room)
they can do a TTE but not a TEE, gotta go to nanning for that. anyway, if chest
hair defeats the ekg, i can imagine what pectoral muscles will do to the TTE readings.

by the way, what is the cost of heart cath in western countries without socialized
medicine? that would be the usa, and, uh, well, just the usa.