Cardiac Catheterization

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Post-procedure

After cardiac catheterization, the sheath is removed and pressure is applied to the area—usually for 5 to 15 minutes—to help close holes in the artery or vein made by the sheath. Gauze dressing is taped to the insertion area and the patient must lie on his or her back for 4 to 6 hours while normal blood clotting seals the holes in the artery or vein.

Alternatively, holes made in the femoral artery (i.e., the large artery in the groin) can be sealed immediately after catheterization by stitching them closed or plugging them with collagen. If either of these methods is used, the patient may be able to sit up within an hour of the procedure and begin walking within several hours.

Most doctors who perform cardiac catheterization give the patient—and the patient's family—a preliminary report on the results immediately after the procedure is completed. Often they can tell right away whether they think treating with medication is possible, or if angioplasty (the "balloon procedure") or open heart surgery is necessary. Occasionally, the doctor may want to review films taken during the procedure with other doctors before making a final recommendation.

Preliminary results usually are available immediately, indicating whether angioplasty or open-heart surgery is necessary, or if treatment with medication is advisable. Occasionally, other physicians review the angiograms before a final recommendation is made.

Most patients are discharged from the hospital the day after the procedure and the gauze dressing usually can be removed at this time. Taking a shower before removing the dressing can help loosen the tape.

Before leaving the hospital, the patient receives instructions explaining when and to what extent normal activity can be resumed. Heavy lifting and vigorous activity should be avoided for several days to ensure that the artery or vein and the insertion site heal properly. Other specific recommendations depend on the results of the procedure.

For several weeks, there may be a small and relatively painless bruise or lump where the sheath was inserted. If pain, swelling, or tenderness develops, the physician should be notified immediately. This may be a sign of infection or of bleeding where the artery or vein has not sealed properly. Other symptoms that warrant prompt medical attention include the following:

• Chills
• Fever
• Pain or discoloration in the leg
• Shaking

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