Coronary angiogram (or cardiac catheterisation) is a minimally invasive procedure to determine if an individual has coronary artery disease or not. It is usually performed with a small entry in the groin artery. Alternative approaches include the wrist (radial artery, Dr. Szto is also experienced in this approach as well). Dr. Szto routinely uses the vascular ultrasound machine to guide puncture of these arteries, to ensure correct insertion of sheath to reduce the likelihood of trauma or complications afterwards.
After cleaning the groin with an antiseptic, the patient is draped with sterile covering. A local anaesthetic is instilled in the groin area, and a small 1 mm puncture is made to allow a tiny catheter to be inserted up towards the base of the aorta. The catheter is then manipulated to engage the origins of the coronary arteries, and contrast dye is then injected to visualise the artery outlines. Instant digital replay is available.
A total of 8 – 10 “runs” are made with the camera in various angles of the body, to enable the arteries to be visualised fully. A narrowing is then identified, and measures to perform coronary stenting may then be made. Occasionally, we may not have all the right equipment to fix a peculiar or unusual narrowing. In this case, the patient will have to come back for the treatment procedure – stent or rotablator debulking etc.
If multiple blockages are found, coronary artery bypass surgery may be recommended, in this situation, the patient may either be admitted for stabilisation, or be discharged for a future appointment to see a cardiac surgeon.
Coronary Angiogram at Peninsula Private Hospital
Dr. Szto will discuss with you about the indications for coronary angiography in your particular situation. The procedure is carried out in the cardiac catheterisation laboratory adjacent to the operating theatres at Peninsula Private Hospital. Most angiogram procedures are day procedures, meaning you will be admitted and discharged on the same day of the procedure.
Dr. Szto routinely uses a 4 French size cardiac catheter (3 French = 1 mm) – the smallest diameter catheter available, in order to reduce artery puncture trauma. The actual procedure takes about 10 minutes, but the whole process from admission to discharge takes about 4 – 5 hours.
If a blockage is found that can be treated with stenting, this is usually performed right at the same time. After a stent procedure, you will be observed overnight in the coronary care unit before being discharged.
You will not be charged any extra fees for your procedure at the Private Hospital, Dr. Szto subscribes to the “No-Gap Scheme” (your private health insurance covers the gap).
Click to download a pamphlet about coronary angiography.
Click to download a pamphlet about after-angiogram care and resumption of activities.