Cardiac Catheterization - Children's Hospital Boston

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Boston, MA 02115
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My Child Has:

Cardiac Catheterization

Programs that treat this condition

	Pulmonary Hypertension Program		Adult Congenital Heart Service
	Kawasaki Disease Program		Cardiac Surgery Program
	Interventional Catheterization Program		Pulmonary Vein Stenosis Program
	Cardiac Psychiatry Program		Cardiomyopathy Program
	Cardiology Outpatient Services

Cardiac catheterization is a specialized procedure in which a long, flexible tube (catheter) is inserted into a vein or artery and guided into the heart, allowing a close look at the structures inside. It may be performed for the following reasons:

To perform valvuloplasties or angioplasties by inflating balloons in obstructed valves or vessels.
To obtain cardiac tissue samples for biopsy.
To open the atrial septum to alleviate certain types of congenital heart defects that cause an infant to become cyanotic (blue color of the skin, lips and nailbeds due to an insufficient supply of oxygen in the blood).
To place devices that close small holes inside the heart (such as with atrial septal defect or ventricular septal defect), or intentionally block blood flow in a blood vessel (such as with patent ductus arteriosus).
To place wire devices, called stents, in narrowed blood vessels to keep them open.
To conduct an electrophysiologic study (EPS) or a radiofrequency catheter ablation (RFCA) procedure, which identifies the site of an arrhythmia's origin within the heart tissue (in many cases this procedure can eliminate the arrhythmia).

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

How is cardiac catheterization performed?

The procedure is performed by a specially trained cardiologist. Your child's physician will discuss the risks and benefits of the procedure with you and will then obtain written permission (informed consent) from you in order to perform the procedure.

Your child is given a sedative to help him/her relax and sleep during the procedure. Once in the "cath lab," he/she will lie on a small table with a c-shaped x-ray machine surrounding it. Heart monitors and other equipment are nearby. A specially trained staff of nurses, technicians, and physicians will monitor your child and make sure he/she is comfortable during the procedure.

An injection of local anesthetic will be given under the skin where the catheter is going 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 vein toward the heart. The cardiologist uses X-rays, called fluoroscopy, to help visualize the movement of the catheter. The catheter enters the right atrium -- the top right-hand chamber that receives oxygen-poor (blue) blood from the body. Eventually, the tube will be guided into the right ventricle, the pulmonary artery and perhaps the right and/or left pulmonary artery branches.

While inside the heart, several things are done to help evaluate the heart structures, as well as the pattern of blood flow inside the heart, including the following:

Blood samples are drawn from a number of blood vessels and heart chambers, which will allow for calculation of heart function and flow characteristics.
Blood pressure measurements are made inside a number of blood vessels and heart chambers.
A contrast fluid is injected into the catheter and, as it flows inside the heart, X-ray films are made of the path the fluid takes throughout the heart.
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 also may review the data.

What happens after the test?

When the catheterization is complete, the catheter 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. 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.

Your child will be taken to a unit in the hospital where he/she will be 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 your child for relaxation prior to the test, and on your child's reaction to the medication.

After the test, your child's nurse will monitor the 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 of time, providing he/she does not need further treatment or monitoring. You will receive written instructions regarding care of the catheterization site, bathing, activity restrictions and any new medications your child 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.

Contact Children's Hospital Boston Cardiovascular Program physicians for a second opinion.



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