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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.
Learn more about Cardiac Catheterization services at Children's.
A cardiac or heart catheterization or “heart cath” is a minimally invasive procedure which uses thin, flexible tubes called “catheters” to look at and get information about the heart from the inside. To get inside the heart, the catheters are inserted into the big blood vessels in the groin, called the femoral (FEM-or-ul) artery and vein, in the same way an intravenous (IV) line is placed. Sometimes other blood vessels in the neck or arm also are used. The catheters are gently pushed through the blood vessels and into the heart using a type of x-ray called fluoroscopy (floor-OS-co-pee) to guide the placement of the catheters. Once the catheters are in position inside the heart, they can be used to gather different types of information depending on what the doctor needs to know.
There are many different types of catheters that can be used during a heart cath, and each catheter serves a different purpose. Some catheters allow the medical team to take blood samples from different parts of the heart and from the lungs to look at oxygen saturation (how much oxygen is in the blood), or they can help measure the blood pressure in the heart and lungs. Others allow the doctor to look at the electrical system of the heart. By inserting a special dye called “contrast” through the catheters and looking at it under fluoroscopy, the doctor can see the heart, and the arteries and veins in the heart and lungs. The doctor can see how well the heart is pumping and take pictures of it so that they can be looked at later.
At the Heart Institute, the doctors and nurses work as a team with many other medical professionals. Among the team members is a pediatric anesthesiologist, who will give your child the medications 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 pediatric cardiologist who specializes in heart catheterizations will do the procedure, and may be assisted by a cardiology fellow, who is a pediatric doctor training to be a heart specialist.
An intervention is the term used when the doctor uses devices to fix or improve a heart condition during a heart catheterization. Today, many heart conditions can be treated during an interventional heart cath that in the past would have needed a separate surgery.
An interventional heart cath will be done by a pediatric interventional cardiologist, who is a heart specialist trained to do heart caths and corrective procedures in children, and, in some instances, adults as well.
During an interventional heart cath, the doctor can use a number of special catheters, balloons, and devices to open or close holes in the heart, widen narrowed vessels, close or plug abnormal or extra vessels, and improve or repair other heart conditions.
Interventions such as these can save the lives of critically ill children, delay or avoid the need for surgery, or help prevent illness or heart failure.
A device is a special piece of medical equipment that is put into the heart or lungs through the catheters that are placed at the beginning of the heart cath. Devices are used for many reasons and each one has its own way of helping the heart. These devices are secured inside the heart and usually will not be replaced or taken out.
Your child’s doctor will explain to you what devices he or she plans to use before the interventional heart cath, which will depend on what he or she finds during the procedure. After the interventional heart cath, the doctor will tell you which specific devices were used for your child.
There are risks and benefits to all medical procedures performed. The benefits of doing a heart cath will be discussed with you prior to the procedure, many times in a special “pre-catheterization clinic visit” at the Heart Institute. This visit can take place in the days or weeks before the cath day. Risks to this procedure are very low, and will be discussed in detail prior to the cath. They include infection, arrhythmia, heparin use, clot formation, stroke, blood loss, blood transfusion, cardiac arrest, death, pulse loss, vessel damage, allergic reaction, bruise, or hematoma formation at catheter sites. There may be additional risks pertaining to the specific intervention being performed. These risks also will be discussed in detail prior to the procedure, and your questions answered, so that you can make an informed decision about your child’s care.
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.
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 catheterization 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.
You and your child should come to the hospital prepared for an overnight stay. As soon as the heart cath is done, your child will be moved to a recovery room until the effects of anesthesia begin to wear off. The doctor performing the procedure will come and speak to you once it is complete to review the results of the cath. You will be called to the recovery room so that you can be there as your child 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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