Cardiac catheterization is a common procedure that allows doctors to examine the heart. A thin tube is inserted into a blood vessel in the leg or arm until it reaches the heart. The catheter allows you to check the pressure within the heart muscle, inject contrast fluid for x-rays, take blood samples, perform a cardiac biopsy, or analyze structural problems in the heart's valves and cavities. As it is an invasive procedure, it is very important to minimize the risk of infection before and after the surgery.
Steps
Part 1 of 3: Clean Site Before Catheter Insertion
Step 1. Shave the area if your doctor asks
Ask the cardiologist if you need to remove hair from the catheter access points. If your doctor tells you not to, chances are the OR team will take care of it during the procedure. The possible access points are:
- Arm;
- Neck;
- Groin.
Step 2. Wash if your doctor tells you to
Follow any specific instructions given to you to shower and wash the night before or the morning of your surgery.
- You may need to shower and wash the access points both in the evening and in the morning before going to the hospital.
- Your doctor may give you a special antibacterial soap that reduces the number of bacteria on the skin and therefore the chances of infection.
Step 3. Remove any unnecessary personal belongings from the body
Keep your hearing aids, if you are using them, so you can hear the doctor's instructions during the preparation phase. However, there are other non-sterile items that can get in the way of the surgeon, for example:
- Jewels;
- Nial Polish;
- Contact lenses;
- Dentures;
- Glasses (bring them with you so you can put them back on at the end of the surgery);
- Chest or abdomen piercing. Inform your doctor of their presence, so that they are aware of it.
Step 4. Follow the cardiologist's instructions regarding drug therapy
Before catheterization, you should inform the surgeon of all medicines you are taking, when you take them and for how long. This list should also include vitamins, herbal remedies, supplements, and over-the-counter medications. Bring a list of medicines or the original packaging with you.
- If you are taking anticoagulants or blood-thinning medicines, your doctor may advise you to stop using them before catheterization. Remember that some over-the-counter medications, such as aspirin, also have an antiplatelet effect.
- Tell your surgeon about any allergies you have, including those to drugs, latex, duct tape, anesthetics, contrast fluids, iodine, or shellfish.
Step 5. Follow your doctor's instructions regarding fasting
You will likely be told how much you can eat and drink in the 24 hours prior to surgery. This is an important detail and you must follow the instructions to the letter because being on a full stomach could cause some problems for the anesthetist.
- In all likelihood, you won't be able to eat and drink for eight hours before the procedure.
- Take any medications that your surgeon has prescribed for you; you can swallow the pills with a sip of water. Do not stop all other therapies unless directed to do so by your doctor.
Part 2 of 3: Reduce the Risks of Infection
Step 1. Stay away from sick people
If you are unwell, even from a minor ailment like a cold or the flu, your immune system is compromised and there is a greater risk of developing complications. If you wake up on the morning of the procedure with a fever, cough, runny nose, or other symptoms, notify your doctor promptly.
- Wash your hands after shaking other people's hands and before eating. In this way, you reduce the chances of exposing yourself to pathogens carried by other individuals.
- Don't approach, hug or shake hands with people with the flu or cold.
- Avoid staying in small and crowded environments. These are situations that favor the exchange of pathogens. Do not take public transport, such as the subway and buses.
Step 2. Strengthen your immune system by managing stress
Emotional pressure causes hormonal and physiological changes in the body, which over time weaken the immune defenses. By relieving stress and anxiety before the procedure, you help your body stay healthy. Here are some suggestions:
- Learn as much as possible about the procedure. The doctor and the hospital staff can give you all the information. Many clinics provide brochures that can also be viewed online. Ask the surgeon or the hospital secretary if it is possible to have such material. In this way, you know the best of the surgery, what to do before and after the surgery.
- Try relaxation methods. These techniques are designed to control thoughts, emotions and the physical response to stress. Many people benefit from deep breathing, meditation, viewing calming images, and progressive contraction and relaxation of various muscle groups throughout the body.
- Ask your doctor for advice before starting a new exercise routine. It may suggest how to proceed safely. This is important because your doctor may assess strenuous activities as unsafe, based on your health condition. If your doctor allows it, you can go for walks or yoga.
Step 3. Ask the surgeon if it is appropriate to go to the dentist
This is a precaution that is sometimes taken before heart surgery. This reduces the chances of neglected oral infections spreading bacteria in the bloodstream to the heart. Tell the surgeon:
- The type of dental work you need to perform and when it was scheduled;
- If you have untreated oral infections.
Step 4. Stop smoking
Breaking this habit is one of the most important behaviors towards a healthy life. Smoking damages your heart and makes you more susceptible to infections, including severe lung infections, as well as increasing the risk of complications from:
- Thrombus;
- Difficulty in breathing.
Part 3 of 3: Caring for the Wound at Home
Step 1. Call the ambulance in case of severe bleeding or infection
In this situation, you need immediate medical attention to treat the infection and avoid losing too much blood. Here's what to monitor:
- Sudden severe edema at the site where the catheter was introduced. It is important to treat an active infection early to prevent it from reaching the heart and other vital organs.
- Bleeding that doesn't stop. If lying down and applying pressure to the wound cannot get the blood to clot, you need medical help. Call 911 and follow the operator's instructions to be able to stop the bleeding.
Step 2. Call the surgeon if you show any signs of developing complications
If you notice the symptoms described here, you should contact your cardiologist immediately, who may advise you to go to the emergency room. The wound needs professional care if:
- You feel numbness or tingling in the arm or leg where the catheter was inserted
- The hematoma becomes larger. This means that there is subcutaneous bleeding;
- The wound is swollen or oozes fluid;
- Have you got a fever.
Step 3. Follow the surgeon's instructions for washing the wound
Your doctor will likely tell you to flush the catheter insertion site every day to avoid infections. The affected area may show some swelling, a bruise, a pinkish color, or a small lump about 12mm in diameter. Your cardiologist may advise you to:
- Change the dressing every day. If you need a more complex bandage than a simple band-aid, the nurse will show you how to change it before you are discharged.
- Gently wash the area with soap and water. Do not rub, otherwise you can reopen the wound.
- Don't apply lotions, medications, or ointments to the area unless your doctor tells you to.
Step 4. Avoid infecting or reopening the incision
You can promote wound healing by keeping it clean and dry. There are also many other precautions you can take to avoid the chances of infecting or reopening it. Your doctor will tell you to rest for a certain amount of time, based on your medical history, as well as giving you the following instructions:
- Don't bathe, don't use the whirlpool, and don't go swimming for at least a week or until your surgeon sees fit.
- Wear loose-fitting clothing that doesn't create friction on the wound or that gets stuck in the scab.
- Do not lift weights over 5 kg for the first seven days. This means you don't have to do any house cleaning or go shopping. You will need to reheat frozen food to avoid going to the supermarket.
- Rests. You will probably feel tired. Take naps if you feel the need. Avoid strenuous sports like running, golf, bowling, or tennis. Climb the stairs carefully and slowly. If you get bored, look for quiet manual activities or read a novel. Rest for at least five days.
- If the catheter was inserted into the groin, don't push too hard when you defecate, as this could reopen the wound.
- Drink eight to ten glasses of water a day. This way you stay hydrated, promote recovery and eliminate any dye that was used to take the x-rays.
Step 5. Follow the surgeon's directions to return to your normal life
Don't get tired trying to do too many activities right away, otherwise you lower your immune defenses and make you more vulnerable to complications. Ask the doctor:
- When you can go back to work;
- How long do you have to abstain from sexual intercourse;
- When you can drive again. If you are in good health and recovery is proceeding as expected, you may be back behind the wheel within 24 hours;
- If you need to change drug therapy. If your cardiologist has prescribed new medicines for you or has changed the dosage of the ones you are using, make sure you understand his advice regarding the dosage and how often you should take them.
- Show up for follow-up visits as directed by your doctor.
