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When Your Child Needs Diagnostic Cardiac CatheterizationBoy lying on table under surgical drapes. Two healthcare providers in surgical gowns, masks, and gloves are holding catheter and watching monitor.

Diagnostic cardiac catheterization is a procedure that can be used to evaluate heart problems. During the procedure, a thin, flexible tube (catheter) is inserted through the skin into a blood vessel. It’s then guided into the heart with the help of live X-rays. Cardiac catheterization is performed by a pediatric cardiologist (doctor who diagnoses and treats heart problems in children). He or she has special training in cardiac catheterization.

Why Diagnostic Cardiac Catheterization May Be Done

  • Your child may need this procedure if a heart problem is suspected or to follow a known heart problem.

  • It may also be needed if your child is being prepared for heart surgery and information on the heart is required before treatment.

  • The procedure allows the cardiologist to:

    • Check the structure of the heart and blood vessels.

    • Measure oxygen levels and blood pressure in the heart and blood vessels.

Before the Procedure

  • Don’t give your child anything to eat or drink for 4–6 hours before the procedure.

  • Follow all other instructions given by the doctor.

Let the doctor know if your child:

  • Recently had a cough, fever, runny nose, groin infection, or diaper rash.

  • Has any allergies.

  • Is taking any medications.

During the Procedure

The procedure takes place in a catheterization laboratory. It lasts about 2–4 hours. You’ll stay in the waiting room during the procedure.

  • Your child lies on an X-ray table.

  • Your child is given a pain reliever and a sedative (medication that makes your child relax or sleep). This is done by mouth or an intravenous (IV) line. He or she may also be given anesthesia (medication that makes your child sleep and not feel pain). This is done by facemask or IV. A trained nurse or doctor (anesthesiologist) is in charge of this process.

  • A breathing tube may be placed in your child’s trachea (windpipe). Special equipment monitors your child’s heart rate, oxygen levels, and blood pressure.

  • A local anesthetic (medication so your child won’t feel pain) is injected at the catheter insertion site. This can be in the groin or arm.

  • Then a catheter is passed through a blood vessel and is guided into the heart. The movement of the catheter can be seen with live X-rays.

  • Contrast dye is injected through the catheter. The dye tracks the movement of blood through the heart and allows the structures and blood vessels in the heart to be seen more clearly. Pictures are taken of the heart and blood vessels using X-rays.

  • Blood samples are drawn from the chambers and blood vessels in the heart. Oxygen levels and blood pressure are measured.

  • The catheter is removed once the procedure is complete.

Risks and Possible Complications of Cardiac Catheterization Include:

  • Reaction to sedative or anesthesia

  • Reaction to contrast dye

  • Arrhythmia (abnormal heart rhythm)

  • Infection

  • Bleeding

  • Injury to the heart or a blood vessel

After the Procedure

  • If no immediate treatment for a heart problem is needed, your child will be taken to a recovery room. You can stay with your child during this time.

  • It may take 1–2 hours for the medications to wear off.

  • Pressure and a dressing is applied to the catheter insertion site to limit bleeding. The doctor or nurse will tell you how long your child needs to lie down and keep the insertion site still.

  • Your child may be given only clear liquids for a few hours. This to prevent reaction to any anesthesia if it was given.

  • Any contrast dye your child is given should pass through the body in about 24 hours.

  • An overnight hospital stay may be required. You’ll be given instructions for your child’s home care before he or she leaves the hospital.

After cardiac catheterization, call the doctor right away if your child has any of the following:

  • Pain, swelling, redness, bleeding, or drainage at the catheter insertion site

  • Severe pain, coldness, or a bluish color in the leg or arm that held the catheter

  • Chest pain

  • Fever :

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Shortness of breath

  • Irregular heartbeat

How to Help Your Child Prepare

You can help your child by preparing him or her in advance. How you do this depends on your child’s needs.

  • Explain what will happen during the procedure in brief and simple terms. Younger children have shorter attention spans, so do this shortly before the procedure. Older children can be given more time to understand the procedure in advance.

  • Make sure your child understands which body part(s) will be involved in the procedure.

  • As best you can, describe how the procedure will feel. An IV may be inserted into the arm to give medications. This may cause a brief sting. Your child won’t feel any discomfort once the medications take effect.

  • Allow your child to ask questions. Answer these questions truthfully. Your child may feel nervous or afraid. He or she may even cry. Let your child know that you’ll be nearby during the procedure.

  • Many hospitals have a child life specialist. This person is specially trained to help children understand what to expect during their time in the hospital. Books, videos, dolls, and toys may be used to help explain the procedure to your child. Be sure to ask your child’s doctor about the resources available at your hospital.

 

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