"What is cath-plasty?"

In many Cath Labs, coronary angiograms are done on one day, and coronary interventions at a later date in the same hospital or another hospital. There are many reasons to do so:

a.	The Cath Labs do not have interventional services.
b.	The physician is not trained in interventional procedures.
c.	The physician thinks it is better to delay the procedure so that the angiograms can be better studied.
d.	Physician and hospital reimbursement is better with dual procedures, as they do two procedures on two different days.
e.	Some low volume Interventional Cath Labs may not have enough rooms or may not have sufficient facilities for a diagnostic procedure to proceed into an interventional procedure, which will demand a lot more time and personnel.

Cardiac catheterization is never a benign procedure. It is attended by complications of mortality (1 in 800 patients), stroke (1 in 500 patients), heart attack (1 in 500 patients), catheter-induced coronary dissection (1 in 1000 patients), groin complications of bleeding requiring blood transfusion, and compromise of the femoral or brachial artery circulation requiring surgery, and occasional major contrast reactions. In addition, there are also chances of infection and deterioration of kidney function in some cases.

Cath-Plasty It is the way to go for all future interventions. Less preparation time. Less hospital time. Single invasion. One hospital fee. One physician fee. Better patient satisfaction. Less combined complications. Saving dollars.

Some of these complications, particularly coronary artery dissection and acute occlusions are better handled in an Interventional Lab, which has the backup of an Angioplasty Service and Cardiothoracic Surgical Team. Therefore, it makes all the more sense, better patient safety and convenience, when angiograms and angioplasties are done in the same lab in the same sitting. By doing so, the patient needs to be prepared and pre-medicated only once, and moreover the arterial system to be invaded only once. This combined procedure of angiogram and angioplasty in the same sitting is commonly called cath-plasty.

In addition to better patient convenience, safety, less lab and hospital time, a less incidence of combined morbidity and mortality is also noted with cath-plasty. Cath-plasty also saves about $4000.00 to $5,000.00 per patient rather than when angiogram and angioplasty are done as separate procedures.

When CAD patients are properly selected and processed for coronary angiography, 40-50% of them are candidates for percutaneous interventions of angioplasty or stenting, about 30% of them are candidates for bypass graft surgery, and the remaining are for medical management.

Combining angiogram and angioplasty in the same sitting (cath-plasty) is the fastest growing segment of interventional work in any major cath lab in the United States, like Rochester General Hospital in New York.

I have been practicing this discipline of combining angiograms (diagnostic tests) and angioplasties (a treatment procedure) in the same sitting for the last one-decade to the best of satisfaction and convenience to my patients, families, and referring physicians.