Therapeutic cardiac catheterizations for children with congenital heart disease

A therapeutic cardiac catheterization is a procedure performed to treat heart defect. A doctor will use a special techniques and a thin plastic spaghetti-like tube or catheter that goes to the heart from blood vessels in the legs or the neck. These techniques allow the repair to be done without surgically opening the chest and heart. The types of defects that can be repaired include closing a hole in the wall that seperates the heart's right and left sides, widening a narrowed vessel or stiff valve, and closing abnormal blood vessels using a variety of devices.

The doctor will decide whether your child willl receive sedation only or general anesthesia. Before entering the cardiac catheterization laboratory (cath lab), a medication may be given to help your child relax and fall asleep.

If sedation chosen, your child will also have an IV started. This allows medications to be given to keep your child asleep and pain-free during the procedure. Your child will keep breathing on his own, and no breathing tube will be needed . Sometimes a topical numbing cream may be applied to both an IV site and to groin area where the catheters will be placed.

If the doctor chooses general anesthesia as best for your children, you will most likely meet with an anesthesiologist prior to the catheterization. Either an inhaled gas via a mask or an intravenous medication may be used for general anesthesia. After your child asleep, a breathing tube tube is inserted into the airway to make breathing easier. Additional medications and fluids may be given throughout the procedure to keep your child comfortable. When procedure is over, the breathing tube will be removed when your child is breathing on his own.

Catheterization is a sterile procedure performed using small catheters placed into blood vessels, so the risk of infection is minimal. Antibiotics aren't usually needed before or after the procedure. Removing the catheter, however, may cause blood to ooze into the skin. This can discolor the skin, like a black eye, but it doesn't usually cause problems.

The catheter doesn't hurt the heart and isn't painful once inside the heart, but its movement can cause abnormal heart rhythms. Your doctor can usually treat these rhythms by removing the catheter or using medications. Rarely, if the catheter touches the heart electrical system it can interfere with the spread of electricity. This is known as heart block. Although this is usually temporary, placing a special catheter connected to an electrical battery (pacemaker) may be required until the heart's electrical system corrects itself.