 A Swan-Ganz catheterization is a

type of pulmonary artery

catheterization procedure.

 It’s a diagnostic test used to

determine whether any
hemodynamic, or blood flow-related,
abnormalities exist in the heart and
lungs. It can be a useful test for
people who have recently had heart
problems, such as a heart attack.
 The procedure involves the insertion of a
pulmonary artery catheter (PAC) into the
right side of the heart and into the arteries
that lead to the lungs. The PAC has a
balloon tip. The balloon allows the catheter
to be carried by the flow of your blood to the
place in your heart where it’ll be used.
 Because your blood takes the catheter
where it’s needed, imaging isn’t needed to
help guide it. Therefore, the procedure can
be done at your bedside. The PAC is also
known as a Swan-Ganz catheter, or right
heart catheter.
 The procedure itself is sometimes called
right heart catheterization. This is because it
can measure the pressure of your blood as
it flows through the right side of your heart.
It measures the pressure at three different
places:
 right atrium
 pulmonary artery
 pulmonary capillaries
 These measurements can be used to figure
out the amount of oxygen in the blood of the
right portion of your heart. It’s also used to
figure out how much blood flows out of your
heart overall.
The PAC may be inserted while you’re in an intensive
care unit or a special lab area. The procedure
generally follows several steps:
1.You’ll be given a sedative to help you relax, but not
put you to sleep.
2.The area where the PAC will be inserted will be
shaved, cleaned, and numbed with local anesthesia
so you don’t feel any pain. It’s usually inserted in the
neck or groin.
3.The doctor will make a small cut to allow the PAC to
enter through a vein.
4.An introducer sheath, or hollow tube, will be placed
into the vein first. This allows for the catheter to enter
your body more easily.
5.The catheter is then directed through the veins and
into the right side of the heart.
6.The doctor will then measure the blood
pressure in the pulmonary artery.

7.A blood sample may be taken to

check blood oxygen levels, or heart
medications may be administered to
check your heart’s response.

8.When all the tests are complete, the

equipment will be removed and
the incision wound will be closed with
stitches.
During the procedure, your heartbeat will be
closely monitored using an electrocardiogram
(EKG) machine. You’ll be awake during the
procedure, but you shouldn’t feel pain. You may
feel a slight pressure where the catheter is
inserted.

The amount of time the PAC stays in the heart

depends on the person. For very ill people who
require more intense monitoring, the PAC may
need to stay in place for a few days.
 A coronary angiogram is a procedure that uses
X-ray imaging to see your heart's blood vessels.
The test is generally done to see if there's a
restriction in blood flow going to the heart.

 Coronary angiograms are part of a general

group of procedures known as heart (cardiac)
catheterizations. Cardiac catheterization
procedures can both diagnose and treat heart
and blood vessel conditions. A coronary
angiogram, which can help diagnose heart
conditions, is the most common type of cardiac
catheterization procedure.
During a coronary angiogram, a type of
dye that's visible by an X-ray machine is
injected into the blood vessels of your
heart. The X-ray machine rapidly takes a
series of images (angiograms), offering a
look at your blood vessels. If necessary,
your doctor can open clogged heart
arteries (angioplasty) during your coronary
angiogram.
 Percutaneous transluminal coronary
angioplasty (PTCA) is a minimally invasive
procedure to open up blocked coronary
arteries, allowing blood to circulate
unobstructed to the heart muscle.
 The procedure begins with the doctor
injecting some local anesthesia into the
groin area and putting a needle into the
femoral artery, the blood vessel that runs
down the leg. A guide wire is placed through
the needle and the needle is removed. An
introducer is then placed over the guide
wire, after which the wire is removed. A
different sized guide wire is put in its place.
 Next, a long narrow tube called a diagnostic
catheter is advanced through the introducer
over the guide wire, into the blood vessel.
This catheter is then guided to the aorta and
the guide wire is removed. Once the
catheter is placed in the opening or ostium
of one the coronary arteries, the doctor
injects dye and takes an x-ray.
 If a treatable blockage is noted, the first
catheter is exchanged for a guiding catheter.
Once the guiding catheter is in place, a
guide wire is advanced across the blockage,
then a balloon catheter is advanced to the
blockage site. The balloon is inflated for a
few seconds to compress the blockage
against the artery wall. Then the balloon is
deflated.
 The doctor may repeat this a few times,
each time pumping up the balloon a little
more to widen the passage for the blood to
flow through. This treatment may be
repeated at each blocked site in the
coronary arteries. A device called a stent
may be placed within the coronary artery to
keep the vessel open. Once the
compression has been performed, contrast
media is injected and an x-ray is taken to
check for any change in the arteries.
Following this, the catheter is removed and
the procedure is completed.