Diagnostic Cardiac Catheterization
Coronary and sometimes ventricular angiography without intervention — used to characterize coronary anatomy before CABG, assess graft patency, evaluate cardiomyopathy, or investigate unexplained heart failure. Increasingly supplanted for anatomy-only questions by coronary CTA, but remains the gold standard when functional assessment (FFR, iFR) or intervention pathway is anticipated.
Clinical pathway
- Radial access (default) or femoral, short sheath.
- Coronary catheter selection — JL4/JR4 diagnostic catheters for left/right coronary, engage ostia under fluoroscopy.
- Contrast cineangiograms — standard 6–8 views: LAO/RAO cranial and caudal angulations to open bifurcations.
- LV gram if indicated — pigtail catheter, power injection, assess wall motion and EF.
- Hemodynamics — right heart catheterization in selected cases (PA pressures, cardiac output).
- Closure — radial band or femoral manual compression / closure device.
Typical systems
- Philips Azurion 3 (single-plane diagnostic)
- GE Innova 2100-IQ
- Siemens Artis Q
Room + procedure characteristics
- Procedure time: 20–40 min
- Contrast: 50–100 ml typical, watched carefully in CKD
- Dose: short fluoro time, low relative to PCI