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Right Heart Catheterization Procedure


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#1 4mysis

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Posted 03 March 2011 - 03:22 PM

My sister recently had an echocardiogram which resulted in mild pulmonary hypertension. Her doctor now wants her to have the right heart catheterization (RHC) procedure. After reading about the risks involved I am very concerned and wondered if anyone has been through this procedure. I know she has to have it done, but my grandmother had a bad experience with angioplasty that caused her to have a stroke during the procedure. I know angioplasty is different than RHC and wondered if anyone can provide any insight.

Appreciate any help!

#2 Jeannie McClelland

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Posted 03 March 2011 - 04:10 PM

It's a valid concern - any 'invasive' procedure has its risks, but RHC has become pretty routine. When I had mine done, there was a whole team of doctors and nurses in the catheterization lab so I felt pretty reassured that if there appeared to be a problem in the making, someone would spot it early. The folks who do RHC's do lots of them too. The only problem I had was that the lab was seriously cold! I thought I'd never get warmed back up. :)

One thing to remember - the angioplasty is dealing with a blocked artery and the potential for a clot to move and cause a stroke is much higher than in a RHC.

The good thing about a RHC is that they measure actual pressures, rather than estimating them. There's often a lot of difference between the estimated and actual numbers and that can bring good news too. If the numbers are lower with RHC, the diagnosis of pulmonary hypertension might even be withdrawn. Even if it stands, the RHC is useful in determining treatment and prognosis.

If I were given a choice between a RHC and going on a vacation to a nice sunny (warm!) beach, I'd still rather have the vacation, but I wouldn't worry about having another RHC either.

I hope everything works out well with your sister. Please give her my best wishes,
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#3 Amanda Thorpe

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Posted 03 March 2011 - 04:43 PM

Hello

I have had a right and left heart catheterisation but then I'm greedy! For me the worse thing was not being able to eat until after the procedure. Like Jeannie has said it's the best way to measure the pressure in the heart and is carried out with great regularity. There is a risk with every procedure but there are also benefits and knowing the exact pressure in the heart is a great benefit particularly if it improves the pulmonary hypertension diagnosis.

Please let us know how your sister gets on.

Take care.
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#4 Joelf

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Posted 03 March 2011 - 04:47 PM

Hi 4mysis,

Welcome to these forums to you and your sister!!

We've already spoken in the chat room a few weeks ago and it's great that you've been able to post today. Thankfully I don't have pulmonary hypertension, so can't advise you about RHC from my own experience; however we do have a link here which I hope will be helpful to your sister and yourself.

I'm not sure whether you said your sister is seeing a Scleroderma expert but we have a list here should she wish to consult one. It's always advisable as sadly many rheumatologists lack the specialist knowledge to deal with such a complex disease as Scleroderma.

Do please post again and let us know how your sister's RHC surgery goes.

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#5 4mysis

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Posted 03 March 2011 - 05:10 PM

Thank you both for your insight. Reading about procedures is always more scary than hearing actual people that have gone through one. I don't know any people personally with sclero except for my sister. We're both learning as the years and her sclero progress. So it's great to have this wonderful community to reach out to! :VeryHappy:

My sister also mentioned that her doctor said the procedure is not as bad because they go through the vein. I didn't read that in any documentation. It only states the arteries. Did my sister hear right? Also did you have any restrictions after the procedure like staying rested for a day or two?

And thanks for all the wishes! I will pass them along to my sister! It may be a couple months before she has it done, but we know she does need it.

Wendi

#6 4mysis

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Posted 03 March 2011 - 05:14 PM

Hey Jo

Can't believe you remember me! Yes, my sister is now seeing an expert who is actually associated with this site. That's how I came to find this great site! I think she is definitely in better hands, but there certainly is always lots more to learn as things move forward.

I've been begging her to join as well, but she's not the computer person ... I'm still trying though!

Wendi

#7 CraigR

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Posted 04 March 2011 - 12:38 AM

I've had three right heart catheterizations. I choose it over just about any trip to the dentist...

The worst part is the little sting when the numbing med is given. Otherwise you just lie there.

It might be a good idea to be sure that it is performed by someone who does it routinely, or through an institution that deals with pulmonary hypertension.

Craig

#8 Joelf

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Posted 04 March 2011 - 08:26 AM

Hi Wendi,

Hope to speak to you again in the chat room .....and your sister as well if you can persuade her to take up the computer!! :yes:

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#9 miocean

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Posted 05 March 2011 - 10:08 AM

Wendi,
I've had both a right and left heart catherization. The procedure is nothing to worry about but there are some questions one should ask prior to it. I found these things out prior to my second one when I was getting close to a kidney transplant and really researched it:

1. Are they doing a right, left, or both side catherization and why? My first one was a left heart, which was necessary for me to get cardiac approval for a transplant but did not give my scleroderma doctor the numbers she needed for pulmonary hypertension. My second one was done by a different doctor and he did both.

2. If they find a blockage during the procedure, what will be done? Will they put in a stent? I found out that the hospital I had my first one at was not equipped to put in stents, so if a blockage was found, I would have to undergo the procedure at a different facility to do so.

3. If they put in a stent, what kind will it be? There a some that are medically treated that have had controversy over the past few years and I read that I could NOT have that kind because of being so close to transplant.

4. What will they use to close up the incision? The first time the doctor used a collagen plug, the second time a star clasp. I had to carry a card around with me for 90 days saying I had a collagen plug. The star clasp is metal so I have to remember to say I have metal in my body when I have an MRI.

5. How long will I have to lay flat afterwards? To keep a clot from forming, you have to lay flat for several hours. With the collagen plug the time is shorter for some reason.You can end up being in the hospital many hours between the prep, the procedure and the recovery. Once I was overnight.

6. Are there any side effects from the dye used? You have to drink a lot of fluid after to release the dye from your body. Since I was on dialysis, I had to be dialyzed after it, which is why I was overnight once, by the time it was over, the it was too late to get dialysis, so I had to wait until the next day. I have since learned that the dye can damage the kidneys so if there is any loss of kidney function already, extra caution needs to be taken.

I discovered most of the things after the fact. Go in prepared with the right questions and informed. I hope this helps.

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#10 miocean

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Posted 20 March 2011 - 04:51 PM

Addition to #6 Right Heart Catherization;

When my scleroderma doctor revisited a repeat of a right heart catherization in the future I expressed my concern over the dye used and the effect on my transplanted kidney. She said they would NOT use dye to determined pulmonary hypertension, that dye is only used to detect clots. A scleroderma patient should NEVER have dye or contrast in tests. So that is another question to ask, or just insist on no contrast.

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#11 bendofislands

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Posted 28 March 2011 - 02:33 AM

I had one done in the United Kingdom when there was concern regarding P.H. My father had also had one in past and had said 'It sounds much worse than it is".

This was what the wonderful consultant in the famous London hospital told me as well. They were both right.

I agree I would much rather not have it at all, but it was far far less traumatic than the many many dental procedures I have had to go through over the years. It also showed that I didn't have P.H., and that was the best news in the world. I had a very interesting talk with the nurse while we waited for one of the team to arrive. This was a mobile unit that they travel with all over the United Kingdom. It was actually in the car park. I thought it really funny that I got put to bed in a gown, along comes the attendant with a trolley, I get wheeled into the car park, I get off and climb the stairs into the mobile unit. Afterwards the reverse!! There were two consultants, two technicians and a nurse. I was very well attended and the consultant told me the results before I left a couple of hours later.

The wonderful British NHS - no charges, no bills just care and attention of the highest order. That was 5-6 years ago and I now live back in Australia.