Left heart catheterization is the passage of a catheter (a thin flexible tube) into the left side of the heart. The procedure may be performed to obtain diagnostic information about the left side of the heart or to treat certain types of heart conditions.

The procedure can also be used to determine pressure and blood flow in the heart's chambers, to collect blood samples from the heart, and to examine the arteries of the heart by a type of x-ray called fluoroscopy.

You will be given a mild sedative prior to the test. An intravenous (IV) catheter is started in your arm to allow medication to be administered during the procedure. A radiologist or cardiologist inserts the catheter through a small incision in the femoral or brachial artery after cleansing the site and numbing the site with a local anesthetic.

The catheter is then carefully threaded into your heart through the aorta and aortic valve and then into the left ventricle using x-ray images called fluoroscopy to guide the insertion. When the catheter is in place, dye is injected to allow the health care provider to visualize the structures and vessels within the heart.

Food and fluid is restricted for 6 - 8 hours before the test.

The procedure takes place in the hospital. Sometimes, admission the night before the test is required. Otherwise, admission as an outpatient or inpatient the morning of the procedure is required.

A health care provider must explain the procedure and its risks. You must sign a consent form for the procedure.

You will be given a mild sedative 1/2 hour before the procedure. The procedure may last from 1 to several hours. You will wear hospital clothing.

The procedure takes place in a radiology department or cardiac diagnostic laboratory. You will be given sedation to relax prior to the procedure, but you will be awake and able to follow instructions during the test. You will remain on a stretcher for the duration of the test.

An insertion is made into an artery for threading the catheter into the left side of your heart. You will be given local anesthesia to insert the catheter, and generally the only sensation is one of pressure at the site. You may experience some discomfort due to lying still for a prolonged period of time.

The procedure is performed to evaluate cardiac valvular disease, heart function and blood supply, congenital heart anomalies, and to determine the need for cardiac surgery. Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and dilate obstructed arteries or grafts in the heart.

Normal heart size, normal heart motion and thickness, normal heart blood supply (if coronary angiography is also performed), normal heart pressures are found.

Cardiac defects or disease may be present. These could include

• Coronary artery disease
• Valvular heart disease (see below)
• Ventricular aneurysms
• Enlargement of the heart.

Additional conditions under which the test may be performed:

• Aortic insufficiency
• Aortic stenosis
• Acute mitral regurgitation
• Mitral stenosis

Risks of the procedure are trauma to the artery, local hematoma at the access site, cardiac arrhythmias, cardiac tamponade, low blood pressure, infection, embolism from blood clots at the tip of the catheter, reaction to contrast medium, stroke, and heart attack.