Cardiac Catheterization

What Is a Cardiac Catheterization?

A cardiac catheterization is a procedure in which a catheter (a long, thin tube) is inserted into a blood vessel. Then, a cardiologist guides it to the heart and the blood vessels around it.

Why Are Cardiac Catheterizations Done?

Cardiac catheterizations can help cardiologists diagnose and treat many different heart problems.

The procedure may be done on kids or teens to:

• Look at how the heart and blood vessels are formed and connected.
• Check the pressures and oxygen levels in the heart and blood vessels.
• Treat a congenital heart defect (a heart problem that a baby is born with).
• Treat an irregular heartbeat (arrhythmia).
• Open up narrowed blood vessels (called angioplasty ).
• Repair leaky or narrow heart valves.

How Should We Prepare for a Cardiac Catheterization?

Your cardiologist will talk with you about how to prepare for the procedure and:

• Give you instructions about when your child should stop eating and drinking (usually 6-8 hours before the procedure for food and 4 hours for clear liquids such as water, apple juice, and broth).
• Tell you which medicines your child should continue taking.
• Discuss the risks and benefits of the procedure.

If your child is old enough to understand, talk about what will happen before, during, and after the cardiac catheterization. Use words your child can understand and let your child ask questions.

What Happens During a Cardiac Catheterization?

A cardiac catheterization is done in a type of operating room called a catheterization lab. There will be an area close by where you can wait until the procedure is finished.

In a cardiac catheterization:

• An intravenous (IV, into a vein) line is put in to give medicines and contrast material through a vein. This special dye helps the cardiologist see the heart's vessels, valves, and chambers more clearly.
• A sedative is given through the IV. This lets your child sleep during the procedure.
• Small sticky patches (electrodes) are placed on the chest. They're attached to an electrocardiograph (ECG) monitor, which checks the heartbeat throughout the procedure.
• The area where the catheter will go in (usually the groin) is shaved (if necessary) and cleaned. The area is sometimes numbed with an injection of medicine.
• A sheath (like a tube about the size of a coffee straw) is inserted into a blood vessel.
• The cardiologist gently guides a catheter through the sheath and blood vessel to the heart. A type of X-ray called fluoroscopy lets the cardiologist guide the catheter to where it needs to be.
• The cardiologist does the test or procedure.
• The catheters and sheath are removed and the site is bandaged.
• Your child moves to the recovery area, where you can join him or her.

What Happens After Cardiac Catheterization?

Your child will be watched closely for several hours after the catheterization. Your child will need to stay lying down with that leg straight until the doctor says it's OK to get up, usually 4–6 hours.

The doctor will also talk to you about:

• pain medicines
• when your child can eat and drink
• continuing medicines your child was on before the procedure or starting new ones
• when to remove the bandage
• if your child should get up and move if you have a long trip home
• when your child can bathe
• when your child can return regular activities, school, and sports

How Can I Help My Child at Home?

Take the bandage off as instructed by the cardiologist, usually the day after the catheterization. Wetting the sticky parts of the bandage will help it come off. Then, dry the area and put a small adhesive bandage over the place where the catheter went in.

Gently wash the area with soap and water at least once a day. Then, cover it with a new adhesive bandage.

For about 2–3 days, your child should take sponge baths or short showers so that the area where the catheter went in does not get too wet. He or she should avoid baths, hot tubs, and swimming, and not use any creams, lotions, or ointments on the area.

Are There Any Risks From Cardiac Catheterization?

Cardiac catheterizations are generally safe procedures. It's normal for the area where the catheter went in to be bruised, sore, or slightly swollen for a couple of days afterward.

More serious problems are uncommon, but can happen. These include:

• bleeding
• allergic reaction to the medicines or contrast material
• heart attack
• stroke
• kidney damage
• long-term problems from radiation from the X-rays

When Should I Call the Doctor?

Call your cardiologist if your child has:

• bleeding where the catheter went in
• swelling or redness that gets worse where the catheter went in
• numbness or weakness of the leg or arm where the catheter went in
• a fever
• chest pain
• trouble breathing

Looking Ahead

Cardiac catheterizations are an important way to diagnose and treat heart problems. Most kids have no problem with the procedure, and are back to their regular activities within a week.