Cardiac Catheterization: When Is It Required?

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November 01, 2023

Cardiac catheterization is a procedure used to diagnose and treat certain heart problems. To do this, the doctor puts a long, flexible tube (catheter) into a blood vessel. The doctor then guides the catheter into the heart to find and treat any problems.In children, cardiac catheterization is done by a pediatric cardiologist. This is a doctor who diagnoses and treats heart problems in children. He or she has special training in cardiac catheterization.

Why A Child Need Cardiac Catheterization?

A child may need a cardiac catheterization to diagnose a heart problem (diagnostic cardiac catheterization). Or a child may need a catheterization to fix a problem (interventional cardiac catheterization). The problem is often one that he or she was born with (congenital heart defect). Diagnostic catheterization is used less often now. Other tests such as echocardiography, MRI, and CT scans are used instead. A diagnostic catheterization may be done to:

Get a more accurate image of the heart or a heart defect
Check the flow of blood through the heart
Find pressures in different parts of the heart and lungs
Check the heart valves to see if they are working correctly
Measure oxygen levels in different areas of the heart, lungs, and blood vessels
Measure electrical activity in the heart
Check for problems after surgery
Take tissue samples to be looked at in a lab (biopsy)
Check the heart before or after heart transplant

Interventional catheterization has replaced surgery for some procedures. An interventional catheterization may be done to:

Close an abnormal opening between the 2 sides of the heart
Close abnormal blood vessels
Widen a narrow blood vessel or heart valve
Treat a heart beating too fast or too slow (abnormal heart rhythm)

What Are The Risks Of Cardiac Catheterization For A Child?

Cardiac catheterizations in children are usually safe. But there are some risks, including:

Risks from radiation
Risks from general anesthesia, if it is used
Serious drop in body temperature (hypothermia)
Decreased oxygen levels (hypoxia)
Irregular heart rhythm (arrhythmia)
Injury to the heart, heart valves, or blood vessels
Blood loss, which could require transfusions
Allergic reaction to contrast dye or medicines, including anesthesia
Kidney damage from contrast dye
Stroke
Death

What Happens During Cardiac Catheterization For A Child?

The healthcare team will give your child an injection of numbing medicine (local anesthetic) in the area where the catheter is going to be inserted. This is usually the groin. But other blood vessels may be used instead such as the vessels in the neck or bellybutton.
The doctor will put a special tube (sheath) into the blood vessel. The doctor puts the catheter through the sheath. Sometimes more than one catheter is used.
The doctor guides the catheter through the blood vessel to the heart. The doctor uses moving X-rays (fluoroscopy) to help see where the catheter is.

For diagnostic catheterization, the doctor may then:

Take blood samples and measure oxygen levels in each of the 4 heart chambers and each blood vessel
Measure blood pressure in each chamber and each blood vessel
Inject contrast dye into the catheter and watch the path the dye takes through the heart (angiography)

If repairs are needed, the doctor may:

Use a balloon to open a heart valve or narrowed blood vessel
Put a small support (stent) in the blood vessel to keep it open
Use special catheter tips to fix the walls between the upper or lower heart chambers (atria or ventricles) or abnormal blood vessels
Use a special catheter tip to open a heart valve with heat
Use a special catheter to examine and treat abnormal electrical activity in the heart

When the catheterization is done, the doctor will remove the catheter. Pressure will be applied to prevent bleeding. The healthcare team will put a bandage on the site where the catheter was put in.

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