Cardiac Catheterization
What is a cardiac catheterization (also termed cardiac angiogram, cardiac cath)?
A cardiac catheterization is an invasive diagnostic procedure during which information about cardiac anatomy and function is obtained.
In certain cases, the cardiac catheterization procedure is performed at the same time as a procedure to treat the heart problem.
How is a cardiac catheterization performed?
A thin tube, called a catheter, is inserted into the leg vein and/or artery and advanced to the heart. Blood samples are taken and pressures recorded to help assess heart function. A "dye" is injected through the catheter, and x-rays are taken to identify the structures of the heart. The pictures are examined to determine the type and extent of congenital heart disease. An experienced team of pediatric cardiologists, nurses, and technologists perform this procedure in state-of-the-art laboratories at the Inova Heart Center.
What are the risks?
The risks of cardiac catheterization are low. The most common risks are usually minor and include bleeding from the catheter insertion site in three percent of patients and contrast allergies in one percent of patients. Other complications are more serious, but fortunately rare. These include severe bleeding requiring minor surgery or a transfusion, stroke, heart rhythm problems, kidney damage, and death. These complications occur in about one in a thousand patients. Your Inova pediatric cardiologist can tell you more about your child's specific risks. The benefits of knowing the exact heart condition outweigh the small risks of catheterization.
Preparing for the procedure
Prior to the catheterization, other diagnostic studies will have been conducted such as an EKG, a chest x-ray and an echocardiogram. The pediatric cardiologist may request specific blood tests to be sure the child does not have anemia or kidney problems. The child will not be allowed to eat or drink for a specific period of time before the procedure. Upon arrival at the hospital, some children will have an IV started. Before the procedure begins, the child will receive medicine to make him or her sleepy. This medicine can be given by mouth or through an IV.
During the procedure
In the catheterization laboratory, the child is placed on a narrow x-ray table. Monitoring equipment is attached. The pediatric cardiologist use a catheter to measure pressures in different parts of the heart and blood vessels. The catheter is used to take blood tests to measure the amount of oxygen in the blood in different places in the heart. "Dye" may be injected for use in taking x-ray movies of the heart's anatomy.
After the procedure
After the catheter is removed, there is a period of observation to watch for bleeding where the catheter was inserted. The child is brought to a pediatric unit to be recovered and observed. The child's heart rate, blood pressure and breathing will also be watched. Depending on a variety of circumstances (the time of day of the procedure, type of sedation used, risk for complications, child's overall health status and complexity of the case), the child may go home the day of the procedure or the next day.
After Discharge
After the child is discharged, instructions include the following:
- Quiet play the day of the procedure
- No baths or swimming until the access site scab is healed. Showers are OK.
- No jarring exercise or repeated bending of the leg with the access site (e.g., jump rope, bike riding, contact sports).
- If there is any bleeding from the insertion site, apply direct pressure immediately for 10 minutes (while the child is lying down). Do not remove the pressure. If it continues bleeding, call 911 for immediate assistance while continuing to hold pressure on the site.
