Cardiac Catheterization

Cardiac catheterization is a specialized procedure in which a long, flexible tube called a catheter is inserted into the blood vessels and guided into the heart, allowing a close look at the structures inside. It may also be performed to:

  • Obtain cardiac tissue samples for biopsy (removing tissue to help obtain a diagnosis)
  • Obtain diagnostic information about the heart or its blood vessels
  • Open the atrial septum (a divider between the atrium) in congenital heart problems that causes a child to become cyanotic (blue color of the skin, lips and nail beds due to an insufficient supply of oxygen in the blood)
  • Place devices that close small holes inside the heart or intentionally block blood flow in a damaged blood vessel
  • Place wire devices, called stents, in narrowed arteries to keep them open
  • Determine blood pressure in the heart's chambers, collect blood samples from the heart or examine the arteries of the heart

Cardiac catheterization can be performed on children of any age, even newborns immediately after birth.

Cardiac Catheterization Procedure

The procedure is performed in the hospital by a specially trained cardiologist. A child is given a sedative to help them relax and possibly even sleep during the procedure. Once in the "cath lab," they lay on a small table with a C-shaped x-ray machine surrounding it and heart monitors nearby. A specially trained staff of nurses, technicians and physicians monitor the child and makes sure they are comfortable during the procedure.

An injection of local anesthetic is given under the skin where the catheter is to be inserted. Next, a thin, flexible tube (catheter) is inserted into a blood vessel, most often in the groin area (the crease of the leg where it bends when sitting).

The catheter is guided up the vessel towards the heart. The cardiologist uses x-rays to help visualize the movement of the catheter. For example, the catheter enters the right atrium (the top right-hand chamber that receives oxygen-poor (blue) blood from the body). Eventually, the tube is guided into the right ventricle, the pulmonary artery and perhaps the right and/or left pulmonary artery branches.

While the catheter is inside the heart, several things are done to help evaluate the structure — as well as the pattern of blood flow — inside the heart. Blood samples are drawn and blood pressure measurements are taken from each chamber and blood vessel. Contrast dye is injected into the catheter and, as it flows inside the heart, x-ray films are made of the path the dye takes. X-ray films are made as the catheterization proceeds, enabling your child's cardiologist to review the data after the procedure. If surgery is planned, the heart surgeon may also review the data.


After Cardiac Catheterization

When the catheterization is complete, the catheter(s) will be withdrawn from the heart and the blood vessels. Several gauze pads and a large piece of medical tape will be placed on the site where the catheter was inserted to prevent bleeding. In some cases, a small, flat weight or sandbag may be used to help keep pressure on the catheterization site and decrease the chance of bleeding.

If blood vessels in the leg were used, your child will be told to keep the leg straight for a few hours after the procedure to minimize the chance of bleeding at the catheterization site. The child is then taken to a unit in the hospital where they’re monitored by nursing staff for several hours after the test. The length of time it takes for your child to wake up after the procedure will depend on the type of medicine given to them for relaxation prior to the test, and on their reaction to the medication.

After the test, your child's nurse will monitor their pulse and skin temperature in the leg or arm that was used for the procedure. Your child may be able to go home after a specified period, providing they do not need further treatment or monitoring. You will receive written instructions regarding care of the catheterization site, bathing, activity restrictions and any new medications they may need to take at home.

Depending on the results of the cardiac catheterization test, additional tests or procedures may be scheduled to gather further diagnostic information.


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