Procedures

Right Heart Catheterisation

  • Interventional Cardiology

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About this procedure

This guide provides information about a right heart catheterisation, also known as a right heart study (RHS) procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.

A right heart study is performed in an angiography suite at IntraCare in Epsom. Your cardiologist will be assisted by our team of nurses and other highly skilled personnel.

Both IntraCare and Allevia Hospital will be involved with your care for this procedure. Allevia Hospital is responsible for your admission, preparation and aftercare in the Cardiac Investigation Unit (CIU).

What is a Right Heart Study?

A right heart catheter study is a minimally invasive medical procedure that provides useful information about how well the right side of your heart is pumping. It involves measuring the pressures inside your heart and the main blood vessels of your lungs.

Why do I need a Right Heart Study?

RHS is the gold standard method to diagnose conditions such as heart failure, congenital heart disease, pulmonary hypertension or heart valve disease so that your doctor can appropriately manage your condition. You may also need a right heart study if you are being evaluated for a heart or lung transplant. It is also a valuable tool to differentiate if you have a restrictive or constrictive heart disease.

Before the procedure

Pre-procedure phone call

A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:

  • Your admission time.
  • When you should stop eating and drinking.
  • Medication instructions.
  • Allergies (including medications, contrast dye, dressings/plasters and food).
  • Answer any further questions.

Anticoagulation (blood thinner)

If you are taking a blood thinner e.g. Dabigatran (Pradaxa), Rivaroxaban, Warfarin or Clexane, your cardiologist will advise if you need to stop this medication temporarily for a few days before the procedure.

Warfarin

If you are currently taking Warfarin, please inform IntraCare via email or phone as soon as possible. Our nurses will review your INR levels and advise any medication changes if necessary.

Other regular medications

Please continue to take these unless advised otherwise by your cardiologist. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure.

Reminders for the day of your procedure

  • If you are on regular medication, please bring this with you in its original packaging.
  • Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone in with you.
  • We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
  • You are encouraged to bring a friend or a family member as a support person before and after your procedure.
  • This is commonly a day stay procedure, but please bring an overnight bag with you in case you are required to stay overnight.
  • The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.

Informed consent

As with any procedure, there are potential risks involved. Your cardiologist will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment, or on the day of your procedure.

Your procedure

A small intravenous (IV) line will be inserted into a vein in your arm. This will be used to administer medication to help you relax and to keep you comfortable during the procedure. We may need to remove hair with clippers at the access site for sterile preparation. Please avoid shaving the area yourself as this may cause minor abrasions to the skin, increasing the risk of infection.

Other devices for monitoring blood pressure, heart rate and oxygen levels will be fitted to ensure your safety during the procedure.

The procedure

The test is performed using X-ray and will last approximately 30 minutes to an hour. You will need to lie flat on a movable table beneath an X-ray machine. You will be monitored throughout the procedure.

A small plastic tube (sheath) is inserted into a vein in the neck or in the groin. A catheter tube, called a Swan-Ganz, is then inserted through the sheath and guided into the right side of the heart and pulmonary arteries. The pressure is measured throughout the procedure. You may be asked to hold your breath at times if you are able. A saline solution is injected through the catheter to measure the blood flow.

Once the procedure is complete, the catheters and sheaths are removed, and pressure is applied over the vein to help close it and manage any bleeding.

After your procedure

You will be transferred from IntraCare to CIU, where the Allevia Hospital team will look after you during your recovery, and if appropriate, you will usually be discharged home after 4–6 hours. Prior to your discharge, the nursing staff will give you advice about your medication, procedure site care and resuming your normal daily activities.

Recovery and discharge

  • Following your procedure, it is important that you do not drive for 24 hours. Please ensure you have a family member or friend to drive you home from the hospital, as you may still be under the effects of sedation.
  • You will need to arrange someone to be at home with you on the day of your discharge and overnight to support you in your recovery.
  • Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure:
    • Do not do any activity requiring strength, concentration, or full alertness.
    • Do not make any legal decisions or sign legal documents.

Resuming activities

  • You will be able to return to work the day after having the procedure unless there are concerns from your cardiologist.
  • You can do light exercise after 48 hours.

Medication

Your cardiologist will discuss any medication changes with you, if necessary. If you have any questions regarding your medications after your procedure, please contact your cardiologist.

Follow up appointment

You will be seen in clinic at The Heart Group approximately 1–3 months following your procedure. If you have minor concerns prior to your follow-up appointment, please arrange to see your general practitioner (GP) or contact IntraCare.

Femoral (groin) site care

It is normal to experience some bruising at the puncture site. During the first few days after your procedure:
  • Do not do any heavy lifting (>5kg) or strenuous exercise.
  • Try not to excessively cough, sneeze, or strain as this puts pressure on the puncture site which may cause it to bleed.
  • Do not sit in a bath, hot tub or spa until the skin has healed.
  • Do not cross your legs while sitting.
  • You may resume walking if your puncture site is not painful.
  • If applicable, remove the dressing on your groin once the skin has healed (approximately 3 days).

Haematoma

A haematoma is a collection of blood under the skin that is sometimes painful. A small hard lump (similar in size to a pea) may also be felt under the skin and remain for several weeks:
  • If a large lump (haematoma) occurs, lie down, and get another person to press down firmly on the centre of the haematoma for approximately 10 minutes.
  • If after releasing pressure, the haematoma reoccurs, keep applying the pressure and go to your local accident and emergency department.

Bleeding

  • It is common for there to be a small amount of ooze. If this occurs, re-apply a sticking plaster and lightly press for a few minutes.
  • If there is significant bleeding, you should lie flat, and another person will need to apply firm pressure for 10 minutes. If this does not stop the bleeding, call an ambulance.

Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.

Please show this page and your discharge summary if visiting a GP, afterhours or hospital.
  • If you have any concerns, please contact IntraCare:
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  • Monday to Friday (6:30am – 6:00pm): 09 630 1961
  • After-hours, weekends, and public holidays: 0274 820 763

In case of emergency, always call 111.

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