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At UPMC Children’s Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this procedure, and we invite you to participate. Please read the following information to learn about the procedure and how you can help.
A heart biopsy is a test to see if there are any abnormalities in the muscle tissue of the heart. A biopsy may be ordered if the doctor wants to check for weaknesses or changes in the heart muscle structure, weak heart pumping, other heart function problems, or to check for rejection after a heart transplant.
The heart biopsy is done during a heart catheterization or “heart cath.” The heart cath is a minimally invasive procedure which allows the doctor to look at and get information about the heart from the inside using special catheters and a type of x-ray called fluoroscopy (floor-OS-co-pee). The doctor uses very thin, flexible tubes called “catheters” placed in the neck vein, or sometimes the leg vein, to get information about the heart. The catheter will be inserted into these large blood vessels in the same way an intravenous (IV) line is placed. The catheter is gently pushed through the blood vessels and into the heart using fluoroscopy to guide the placement of the catheter.
Once the catheter is in position inside the heart, the doctor will insert a smaller catheter through it. This smaller catheter has a set of tiny tweezers on the end of it. The tweezers will take a tiny sample of heart tissue that will be pulled back through the catheter.
Getting this small amount of tissue for testing is what is known as a biopsy (BY-op-see). The tissue sample will be sent to the lab to be processed. Results from the biopsy will be available by the next day.
At the Heart Institute, the doctors and nurses work as a team with many other medical professionals. Among the team members who may be in the cath lab with your child is a pediatric anesthesiologist, who will give your child any medications needed to make him or her sleep, and monitor his or her vital signs during the procedure. The cath lab staff also will be involved by preparing your child for the procedure and getting equipment needed by the doctor. A transplant cardiologist will do the heart cath and biopsy, and may work with a cardiology fellow, who is a pediatric doctor training to be a cardiologist.
A biopsy may be needed to check for heart muscle abnormalities or rejection after a heart transplant. Rejection is a serious condition that requires treatment. A heart biopsy can give your child’s cardiologist important information to guide the treatment and management of your child’s condition. As with any medical procedure, there are some risks involved. These risks will be discussed with you prior to the procedure:
When sedation or general anesthesia is needed, there are important rules for eating and drinking that must be followed the night before and the day of the procedure. One business day before your child’s procedure, you will receive a phone call from a scheduling nurse between 1 p.m. and 9 p.m. (Nurses do not make these phone calls on weekends or holidays.) Please have paper and a pen ready to write down these instructions. Your transplant coordinator may also may call you. Please follow the directions your coordinator gives you regarding your immuno–suppressant medications or obtaining lab work prior to arriving at the Same Day Surgery Center.
The most important role of a parent or guardian is to keep your child calm. The best way to keep your child calm is to be calm yourself. Knowing what to expect and explaining it to your child beforehand is the best way for both you and your child to be prepared for this procedure. Here are some guidelines to use when discussing the heart cath with your child.
Your child may bring along a “comfort” item — such as a favorite stuffed animal or “blankie” — to hold during the procedure. There are televisions in the Same Day Surgery rooms, but you are welcome to bring along a portable DVD player, laptop computer, or hand-held video game, if these items will help your child.
Please bring along a “comfort” item for your child, such as a favorite blanket, stuffed animal, or toy.
The day before your child’s heart cath, explain the procedure using simple words. You might explain that the doctor “will take pictures of your heart while you are taking a nap.”
A medical play kit can be helpful so that your child is familiar with items he or she may see. For example, you can show your child how to use a stethoscope on a teddy bear. Books about going the hospital also might be helpful.
Older children may benefit from discussing the heart cath about a week or so before the scheduled date. At this point, kids understand more about the body, the organs, and how they work.
For that reason, they may be more afraid of pain. You might explain to your child that he or she will be getting medication that will make him or her very sleepy throughout the heart cath, and that this medication will keep him or her from feeling any discomfort during the procedure. It also will make it hard to remember much about the procedure afterward.
You might add that the heart is like a pump, and the heart cath will help the doctor understand how well your child’s heart is pumping. Books about going to the hospital also might be helpful.
Preteens and teens are able to understand the way the heart works, what their heart problem is, and why they need this procedure. They might ask very insightful questions. Use their questions to help guide your discussion.
You and your child will register for the heart cath and biopsy at the Same Day Surgery Center, on the 4th floor of Children’s Hospital. You and your child will be called to an examination room where your child’s vital signs will be checked.
As soon as the heart biopsy is done, your child will be moved to a recovery room until the effects of anesthesia begin to wear off. You will be called to the recovery room so that you can be there as he or she wakes up. You can help by talking softly and touching your child so he or she knows you are there.
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Heart Institute before the procedure and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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