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The Patient Journey of Interventional Cardiac Catheterization at University Medical Center Ho Chi Minh City

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Cardiovascular Surgery Department
Interventional cardiac catheterization is an advanced medical procedure that plays a crucial role in diagnosing and treating various cardiovascular conditions, especially congenital heart defects. With its minimally invasive nature, this procedure offers significant benefits, enabling rapid patient recovery and minimizing risks compared to traditional surgery [1]. At University Medical Center Ho Chi Minh City, the interventional cardiac catheterization procedure is systematically performed to ensure optimal safety and effectiveness for patients.

1. What Is Interventional Cardiac Catheterization?

Interventional cardiac catheterization is a medical procedure utilizing a small, flexible catheter inserted into a blood vessel (typically in the groin) and threaded to the heart. This process is continuously monitored using digital subtraction angiography (DSA) imaging, allowing physicians to clearly observe the structures of the heart and blood vessels. The purpose of the procedure may be diagnostic (evaluating intracardiac pressures, collecting blood samples, or heart tissue biopsy) or therapeutic (repairing cardiac defects) [1].

2. Advantages of Cardiac Catheterization

Compared to traditional open-heart surgery, interventional cardiac catheterization offers several prominent advantages:

  • Minimally Invasive: Requires no large skin incisions and leaves no significant scars on the chest.

  • Rapid Recovery Time: Patients can typically be discharged after just 1 day and return to normal activities much sooner.

  • Reduced Pain and Complications: The risk of infection and other complications is generally lower compared to open-heart surgery.

  • Suitable for Various Demographics: Highly effective for congenital heart defects in both pediatric and adult patients.

3. Common Interventional Cardiac Catheterization Treatments

Interventional catheterization is applied in various complex therapeutic techniques, including:

Balloon Valvuloplasty

This technique utilizes a small balloon attached to the tip of a catheter, which is inflated to widen narrowed heart valves (e.g., pulmonary valve stenosis, aortic valve stenosis) [25, 26]. This process improves blood flow across the valve and reduces workload on the heart.

Blood Vessel Dilation / Angioplasty

Similar to valvuloplasty, this technique uses a balloon to widen narrowed blood vessel segments, such as pulmonary artery stenosis or aortic coarctation, facilitating smooth blood flow [22, 24].

Transcatheter Closure of Cardiac Shunts (ASD, VSD, PDA, etc.)

This is one of the most critical applications of interventional catheterization, enabling the closure of abnormal holes in the heart or blood vessels without surgery. Frequently treated conditions include:

  • Atrial Septal Defect (ASD): Closing the opening between the two atria.

  • Ventricular Septal Defect (VSD): Closing the opening between the two ventricles.

  • Patent Foramen Ovale (PFO): Closing the remaining opening after birth.

  • Patent Ductus Arteriosus (PDA): Closing the vascular connection between the aorta and pulmonary artery that fails to close naturally after birth.

  • Aortopulmonary and Venous Collaterals: Closing abnormal blood vessels.

Intravascular Stenting (Patent Ductus Arteriosus Stent, Coronary Stent, Stent Graft)

A stent is a small metal mesh tube placed into the lumen of a blood vessel or cardiac conduit to keep it open. This technique is utilized for:

  • PDA Stenting: Keeping the ductus arteriosus patent when clinically required.

  • Coronary Stent Placement: Widening narrowed or obstructed coronary arteries to improve myocardial perfusion.

  • Stent Grafting: Treating aortic aneurysms or dissections.

Transcatheter Valve Replacement (Pulmonary Valve, Aortic Valve)

This advanced technique allows the replacement of diseased heart valves (typically stenotic or regurgitant) without open-chest surgery [27, 28]. The artificial valve is delivered to the heart via a catheter and deployed at the native valve site. This technique is particularly beneficial for elderly patients or those at high surgical risk.

4. The Patient Journey at University Medical Center Ho Chi Minh City

The patient journey for interventional cardiac catheterization at University Medical Center Ho Chi Minh City is scientifically designed to ensure thorough preparation, safe procedural execution, and effective post-intervention monitoring.

Pre-Procedural Preparation Steps

To ensure maximum safety and procedural effectiveness, patients undergo a comprehensive preparation process:

  • Clinical Examination and Medical History: Physicians review medical history, current symptoms, and ongoing medications.

  • Necessary Pre-clinical Investigations: Patients are prescribed blood tests, chest X-rays, echocardiography, and other cardiovascular functional assessments to accurately evaluate cardiac status.

  • Multidisciplinary Team Consultation for Complex Cases: For complex cases, a specialized cardiovascular team conducts case reviews to establish the optimal treatment regimen.

General Anesthesia and Safety Control for Pediatric Patients

Particularly for pediatric patients, interventional procedures often require general anesthesia. An experienced team of anesthesiologists and technicians strictly manage safety protocols throughout anesthesia administration.

The Interventional Procedure: Performed in the DSA Suite

The interventional procedure is performed in a Digital Subtraction Angiography (DSA) suite—a specialized room equipped with advanced X-ray imaging systems. Physicians introduce a small catheter into an artery or vein in the groin (or occasionally the neck or arm), then gently guide the catheter to the heart. The entire movement of the catheter is displayed clearly on an X-ray monitor, enabling precise manipulation.

  • Procedural Duration: Typically, a cardiac catheterization procedure takes about 30 minutes, depending on individual case complexity.

  • Post-Procedural Monitoring and Recovery: Upon procedure completion, the catheter is removed, and pressure dressing is applied to the puncture site for hemostasis. Immediately following the procedure, patients are monitored in the DSA suite until stable, then transferred to the Department of Cardiovascular Surgery to continue receiving care, vital sign monitoring, and puncture site evaluation.

  • Hospital Stay and Early Discharge: Due to its minimally invasive nature, most patients can be discharged just 1 day after catheterization.

5. Frequently Asked Questions (FAQ)

  • Does cardiac catheterization hurt? Generally, patients receive local anesthesia or general anesthesia (especially children), ensuring no pain is felt during the procedure. Some individuals may experience mild discomfort when the catheter is inserted or mild pressure at the puncture site afterward.

  • What is the recovery time after interventional cardiac catheterization? Due to its minimally invasive nature, recovery is typically rapid. Most patients can walk lightly after a few hours and be discharged within 24 hours. Strenuous activities may need to be restricted for a few days to a week.

  • Are there any special dietary or lifestyle restrictions after the procedure? Following the procedure, patients should avoid strenuous activities, heavy lifting, and submerging the puncture site in bathtub water for a few days. Physicians will provide detailed instructions regarding diet, daily activities, and wound care.

  • When is follow-up required after interventional cardiac catheterization? Follow-up schedules are specifically prescribed by physicians depending on the underlying pathology and procedural outcomes. Regular follow-ups are crucial to evaluate treatment efficacy and detect latent issues early.

  • Are there any risks associated with interventional cardiac catheterization? Although safe, interventional catheterization carries potential risks such as bleeding or bruising at the puncture site, infection, allergic reactions to contrast dye, or rarely, blood vessel or cardiac injury. Serious complications are exceedingly rare.

6. References

  • [1] National Heart, Lung, and Blood Institute (NHLBI). (2022). Cardiac Catheterization. https://www.nhlbi.nih.gov/health/cardiac-catheterization. Accessed: 2025-12-09.
  • [2] Mayo Clinic. (n.d.). Cardiac catheterization. https://www.mayoclinic.org/tests-procedures/cardiac-catheterization/about/pac-20384695. Accessed: 2025-12-09.
  • [3] Tierney, N., Kenny, D., & Greaney, D. (2021). Anaesthesia for the paediatric patient in the cardiac catheterisation laboratory. BJA Education, 22(2), 60–66. https://pmc.ncbi.nlm.nih.gov/articles/PMC8749386/. 
  • [4] Ogawa, Y., et al. (2022). Severe Complications after General Anesthesia versus Sedation during Pediatric Diagnostic Cardiac Catheterization for Ventricular Septal Defect. Journal of Clinical Medicine, 11(17), 5165. https://pubmed.ncbi.nlm.nih.gov/36079095/. Accessed: 2025-12-09.
  • [19] Faccini, A., & Butera, G. (2018). Atrial septal defect (ASD) device trans-catheter closure: limitations. Journal of Thoracic Disease, 10(Suppl 23), S2923-S2930. https://pmc.ncbi.nlm.nih.gov/articles/PMC6174146/. Accessed: 2025-12-09
  • [20] Morray, B. H. (2019). Ventricular septal defect closure devices, techniques, and outcomes. Interventional Cardiology Clinics, 8(1), 1–10. https://pubmed.ncbi.nlm.nih.gov/30449417/. Accessed: 2025-12-09.
  • [22] Zablah, J. E., & Morgan, G. J. (2019). Pulmonary artery stenting. Interventional Cardiology Clinics, 8(1), 33–46. https://pubmed.ncbi.nlm.nih.gov/30449420/. Accessed: 2025-12-09.
  • [23] Sankar, M. N., Bhombal, S., & Benitz, W. E. (2019). PDA: to treat or not to treat. Congenital Heart Disease, 14(1), 46–51. https://pubmed.ncbi.nlm.nih.gov/30811796/. Accessed: 2025-12-09.
  • [24] Batilicala, S. P., & Goldstein, B. H. (2019). Current transcatheters approaches for the treatment of aortic coarctation in children and adults. Interventional Cardiology Clinics, 8(1), 47–58. https://pubmed.ncbi.nlm.nih.gov/30449421/. Accessed: 2025-12-09.
  • [25] Saung, M. T., McCracken, C., Sachdeva, R., & Petit, C. J. (2019). Outcomes following balloon aortic valvuloplasty versus surgical valvotomy in congenital aortic valve stenosis: a meta-analysis. Journal of Invasive Cardiology, 31(5), E133-E142. https://pubmed.ncbi.nlm.nih.gov/31158809/. Accessed: 2025-12-09.
  • [26] Daaboul, D. G., DiNardo, J. A., & Nasr, V. G. (2019). Anesthesia for high-risk procedures in the catheterization laboratory. Pediatric Anesthesia, 29(5), 491–498. https://pubmed.ncbi.nlm.nih.gov/30592354/. Accessed: 2025-12-09.
  • [27] Balzer, D. (2019). Pulmonary valve replacement for tetralogy of Fallot. Methodist DeBakey Cardiovascular Journal, 15(2), 122–132. https://pmc.ncbi.nlm.nih.gov/articles/PMC6668735/. Accessed: 2025-12-09.
  • [28] Martin, M. H., Shahanavaz, S., Peng, L. F., et al. (2018). 

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.

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