HELP Heart catheterization

psu_213, BSN, RN · Oct 25, 2011

Need a bit more information here...anticoagulation during the procedure? How far before the procedure it is stopped? What anticoagulant they take after the procedure? Also, why are you wondering (just curious)?

Ayie · Oct 25, 2011

I guess the overall use of anticoagulation from start to finish. If there's any difference in administering techniques or indications if we're doing a right catheter versus a left catheter, if there really is a difference at all.

I'm asking because my textbook mentioned that there is a difference but I cant seem to find it.

Skip219, BSN, RN · Oct 25, 2011

We do many RHC without heparin and up to inr 2.5. Depending on their pressures the venous sheaths are pulled and manual pressure is applied x 7-10min. For LHC we give heparin if we intervene. If on heparin gtt, we shut it off a.d draw an ACT and give heparin bolus for interventions. We try to get their ACT 250-300

yvfair · Oct 25, 2011

I will try to answer this in layman's terms. A RHC is where the pressures in the heart are checked. A sheath is placed in the femoral VEIN TO CHECK HEART PRESSURES (usually to diagnose CHF or valve problems) and there is usually NO need for anticoagulants. If a patient is on Heparin prior to starting the RHC procedure, then it can be stopped prior to beginning procedure.

On the other hand, during a LHC, a sheath is placed in the femoral ARTERY and coronary arteries are checked for blockage (this is considered diagnostic catheterization). Some old school doctors still give Heparin during diagnostic LHC but it is not necessary. If a patient has 70% or more blockage in an artery that requires a stent and/or angioplasty, then anticoagulants are given such as Heparin, Reopro, Angiomax, or Integrillin to prevent stenosis while stent being placed. Also, a loading dose of Plavix 300-600mg PO may be given to further prevent re-stenosis of artery and closing of stent placed.

So to answer your question, the difference in a RHC VS. LHC IS: RHC is done to check the heart pressures and LHC is done to check coronary arteries for blockage and a stent and/or angioplasty can be done at that time if needed

Skip219, BSN, RN · Oct 26, 2011

The venous side is lower pressure system...a right heart measures the pressures of RA, RV, PA, and pulm capillary bed. Arterial side is high pressure system : impeding flow with catheters, wires, balloons, and stents all increase the chances of clot formation.