Right heart catheterisation

Common reasons for right heart catheterisation:

To directly measure pressures within the heart chambers

To estimate pressure in the lung and connecting blood vessels

To look for abnormal connection (shunting) between heart chambers

What can I expect and how is it done?

You will usually be asked not to eat or drink for 4-6 hours before the proposed procedure. Right heart catheterisation will be performed by Dr Chai at Wexham Park Hospital Cardiac Catheterisation Laboratory (Cath Lab). It is usually done as a combined of left-and-right heart catheterisation, but standalone right heart catheterisation can be easily performed.

Dr Chai will personally explain each step of the procedure to you, prior to your proposed date of the procedure. Although still an invasive procedure, it is generally very safe in expert hands. For right heart catheterisation, serious complication is rare with a 0.1% chance of adverse events most commonly minor pain, bruising and bleeding from puncture sites. There is a very small risk of damage to the arteries within the lungs and mortality.

You will be prepared by a specialist cardiac nurse on the day and a small plastic tube (cannula) pre-inserted into a vein in your arm. Dr Chai will then inject local anaesthetic agent to numb the skin over the access site, mostly commonly at the front of your elbow (Dr Chai performs the vast majority of his right heart catheterisation via the arm, but rarely he may need to access via the top of the leg). A short plastic tube will then be inserted as a sheath to allow longer plastic tube (catheter) to be inserted directly to the heart and lung vessels. Pressures are then directly measured at various locations, and sometimes blood samples may be withdrawn along the way to measure oxygen saturation if an abnormal cardiac shunt is suspected. After your procedure is complete, all the tubes will be removed and pressure will be applied to the puncture site for bleeding control manually.

What will happen after my angiogram?

Dr Chai will discuss the findings of your cardiac catheterisation with you immediately after the procedure. You can go home after a few hours once bleeding controlled. It is important that you have someone to take you home and stay with you for the first night after the procedure. You should look after the wound to facilitate healing and avoid bath / submersion in water for a day or two.