Heart cath?

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john79t

Well-known member
Joined
Apr 8, 2009
Messages
449
Location
Missouri
I got a call from the VA a little while ago and they are wanting to send me to the St. Louis VA for a heart cath. Is a cath usually done for SAS and root aneurysim? Is this done by a cardiologist? I am not really comfortable at this point having this done at the VA. What should I look for and what questions should I ask? If I am not comfortable with this I think I will contact another cardiologist. From what I have read the risk increases with those over 60 I am 61 and those with advanced valve disease. I have SAS ,88. Will this test give more information to a surgeon than the echos I have had done?
 
I got a call from the VA a little while ago and they are wanting to send me to the St. Louis VA for a heart cath. Is a cath usually done for SAS and root aneurysim? Is this done by a cardiologist? I am not really comfortable at this point having this done at the VA. What should I look for and what questions should I ask? If I am not comfortable with this I think I will contact another cardiologist. From what I have read the risk increases with those over 60 I am 61 and those with advanced valve disease. I have SAS ,88. Will this test give more information to a surgeon than the echos I have had done?

The heart cath will check for any coronary artery disease and it will give them a more accurate aortic valve opening measurement. If there are any blockages in the arteries, those might be addressed at the time that you have your replacement.
I've had four heart caths; they are performed by the cardiologist. There is some risk, because it's an invasive procedure, but usually it goes very well. If you're not comfortable with the VA, then seek another cardiologist. It really boils down to an issue of trust.
 
Caths are normal. They get more accurate measurements on what they know is bad, and make sure that there aren't other issues, i.e., blockages, etc. They don't want to be surprised when they get in there.

Every procedure has risks, but caths have been done for quite a while with a low percentage of complications.
 
I called the VA back and the cath was to be done at the VA by a cardiologiat (they did not know who) They also told me that the VA is now sending us to St. Louis U. Hospital. ( completely unacceptible)

I contacted Dr. Marc Moon from Barnes Jewish Hospital. He specializes in AV and root repair. He was trained by Dr. Nick K. I am going to get my echo films and over night them. The dr will rewiew them and decide if I need to come up sooner than April 30 or not. Also his NP is going to call me monday (she was off today) and gather more infomation. Also I called my family dr and am waiting on a call bach from him to see if he can get me a heart moitor to wear for a couple of days to check out the palatations I am having.

This means I go outside the VA and pay my deducts but I don't care. I want a great surgeon and a great hospital,

Does this sound like a good plan?
 
I called the VA back and the cath was to be done at the VA by a cardiologiat (they did not know who) They also told me that the VA is now sending us to St. Louis U. Hospital. ( completely unacceptible)

I contacted Dr. Marc Moon from Barnes Jewish Hospital. He specializes in AV and root repair. He was trained by Dr. Nick K. I am going to get my echo films and over night them. The dr will rewiew them and decide if I need to come up sooner than April 30 or not. Also his NP is going to call me monday (she was off today) and gather more infomation. Also I called my family dr and am waiting on a call bach from him to see if he can get me a heart moitor to wear for a couple of days to check out the palatations I am having.

This means I go outside the VA and pay my deducts but I don't care. I want a great surgeon and a great hospital,

Does this sound like a good plan?

Yes, this is a good plan.:) I'm very happy that you've decided to go this route.:)
I know of Dr. Moon and he is good. :)
I think you did the right thing in stepping outside the VA system and letting the surgeon determine the timing and what further testing needs to be done.
Regarding the palpatations, I wouldn't worry about them too much at this point. They're a symptom only and will be resolved when the valve is replaced.
Are you south of St. Louis?
 
Every Surgeon will want to see the results of a Heart Cath (be sure to have them do BOTH a Left and Right Heart Cath so that they can assess your lung function as well) BEFORE doing Surgery, especially in 'more elderly' patients. The Surgeon wants to know if he will need to do ByPass Surgery as well as Valve Surgery once he 'gets in there'.

The Cath allows for direct pressure readings which can confirm your Echo numbers (with greater accuracy).

Bottom Line about Caths:
They are performed by an Invasive Cardiologist
The More they do, the Better they are.

Find a Cardiologist who lives in the Cath Lab and you should be fine. Our local Heart Center has 25? Cardiologists with a group of 5 or 6 who specialize in caths. I seem to remember that their "incident rate" is 1 in 1000 and most 'incidents' are not fatal. (I don't know the number of fatal results but I'm pretty sure they are not common, especially in otherwise healthy patients).

'AL Capshaw'
 
Thanks Mary.

Glad to know you have heard of him. I am looking forward to meeting with a "real" doctor and not a VA want a be.
 
Mary
I missed your question about St Louis. I am in Poplar Bluff about 2 1/2 to 3 hours away. I have lived in St. Louis in the past and have relatives there.
If DR. K was still at BJH I would use him and still could. Just does not look like the facility is as good and am not sure of the team he has around him now. This site has been a God send to me. Of course I am still scared but feel much better equiped to make the best choices. God Bless. John
 
Mary
I missed your question about St Louis. I am in Poplar Bluff about 2 1/2 to 3 hours away. I have lived in St. Louis in the past and have relatives there.
If DR. K was still at BJH I would use him and still could. Just does not look like the facility is as good and am not sure of the team he has around him now. This site has been a God send to me. Of course I am still scared but feel much better equiped to make the best choices. God Bless. John

Welcome, neighbor!:)
As far as I know, (and according to some around this place . . . heck, make that most . . . :rolleyes: I think I know it all:p:p) you and I are the only VR members in this part of Missouri. There are members in St. Louis, in Columbia, Rolla, and Springfield, but we're the only ones in the Bootheel.
 
Hey Mary.
I am feeling better about some of the choices I am having to make. (Not feeling better about having to make them but thats thebreaks) I went on a heart healthy diet on March 27 and have lost 15 lbs so far. I thought getting 40 or 50 lbs off my at body would reduce the strain on my heart an help with surgery. If I don't get to Dr Moon until April 30 I will be a nercous wreck. But I have done ok this long a couple of weeks should be OK. Thanks for all your advice and support. John
 
John, I've only had one heart cath and it was done by my first Cardiologist. I was 56, he did it just before I had valve surgery to see if I had any plugged arteries. I didn't have any arteries plugged but the doc had a heck of a time getting through my plugged aorta valve. I didn't think he'd ever make it through but he finally did. He had to back completely several times and change the size of the tool.

I don't blame you for questioning VA. I go to our local VA clinic once a year. Only so they will supply me medications for $8 per prescriptions. They recently gave me the run around about supplying me Coumadin because I had been using my Cardiologist for INR testing. I'm not about to let them test me. So I switched to buying my own Warfarin for $4 a prescription.

But I went over to the VA hospital at Little Rock last year for a Shingles shot. I couldn't ask to been treated any better!

Good luck with your heart cath and health.
 
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Olefin Thanks.

I am going outside the VA and using my tri care. I have contacted a really good surgeon who specializes in AVR and root repair. I will see him on April 30 unless the echo I am sending up tells him I need to be there sooner. Just an example of our great VA system: they could not tell me who would do the cath. and if I needed surgery they would send me to St Louis U. hospital. Not going to happen. I called the VA to requestmy echo films and they said come and sign for them and we will overnight them for you. Got there and the VCR (not CD but VCR) broke, no backup VCR no CD. She said they had a work order in on it and thought it would be fixed by monday morning. What do you think the chances of getting a VCR fixed in a government run facility over a holiday weekend? Fortunately I have a surgical RN daughter and a personal doctor friend. I will get another one done monday and get it up there by Tue. Folks crying for government run health care don't have a clue how bad it will be.
 
Caths are done either as a diagnostic tool to, like others have said, ck for accuracy of your echo numbers....or...they are done to clear your plaque (angioplasty). Everyone else has already answered everything else.
 
Get a cath done by a cardiologist AND the nurses he works with. I've had 2 over the yrs and the 1st one went fine. The 2nd time, the nurses at the hospital were on strike and so scab nurses were used. I ended up getting a fluid overload after the procedure and it sent me into congestive heart failure.
My porcine valve was already calcified and leaking and I had to have emergency surgery a few days after the cath to replace it quicker than was expected.
Gail
 
Hi John,

I can certainly understand your anxiety with having a heart cath, and having to us a facility that probably won't give you the care you need just because of your age. I've had 6 or 7 caths since 68 (I'm only 44), but can offer a bit of advice. If you are scared, make sure you let everyone know, e.g. the cath technicians, the cardiologist, the nurses, etc. If they don't offer you a relaxant, ask them for something. Once you have that in your system, you will be more relaxed and the procedure will likely be over and done with before you know it. One other very important point to consider, just in case. If you are on any type of blood-thinning drugs, coumadin, etc., make sure they check your INR before they do anything. My recent cath before my surgery on 3/31 was delayed by one day because everyone forgot to check my INR - I suggested at the time that I do it myself (had my Coagucheck XS with me), but they said it would be okay. It wasn't.

I hope all goes well for you. You plan sounds great.

Best regards,
Roderick
 
I will meet with my surgeon Thursday. I will insist on a CT scan first. I want to know what I am facing as far as any aorta work and the cath will not tell that. When I have the cath it will be at BJH not the VA.
 
One Hint for your Comfort during the Cath -

If you get Back Pain from laying on a Hard Flat Surface,
ask the Cath Lab Technician to fold a Hand Towel lengthwise a couple of times and pull it under the small of your back.

Also ask for a small Pillow to be placed under your Knees.

Believe me, that is MUCH MORE Comfortable.
 
John I first joined this site when I was facing a heart cath and was very anxious. The people here made me so calm I had no relaxation meds ......I did have a cardio who "lives in the cath lab".....he was wonderful.......my only concern is a small clip used to close......most people here have one (more like a plug than a clip) that dissolves....mine does not. I am going to be paying the co-pay for a few years......but that's the least important factor.
 
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