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Outpatient Services and Inpatient Units: (302) 651-6660
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Cardiac Intensive Care Unit: (302) 651-6644
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Pediatric Cardiac Catheterization Expertise
Cardiac catheterization is one of the many pediatric cardiology services our children’s heart experts offer to ensure your child's healthy future. Pediatric cardiac catheterization is a nonsurgical procedure that can be used in infants, children and teens to:
- determine if there’s a problem with the heart (called “diagnostic catheterization”)
- possibly even repair a problem (known as “interventional catheterization”)
Our Catheterization Lab is located in the Nemours Cardiac Center in the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., ranked among the best children’s hospitals in the country for pediatric cardiology and heart surgery by U.S. News & World Report. Our lab (sometimes called the “Cath Lab”) has the most up-to-date equipment and is designed specifically to allow our heart center cardiologists, cardiac surgeons, anesthesiologists and nurses to work side-by-side and perform complicated combined catheterization and surgical procedures when needed.
Many of the procedures we perform in this specialized catheterization lab would otherwise require open-heart surgery with much longer hospitalization and recovery times.
Catheterization in children is performed by inserting a thin plastic, flexible tube (called a “catheter”) into an artery and vein, usually in the groin, and threading it through the bloodstream into the heart and its large blood vessels. There, the cardiologist measures pressures and blood oxygen levels and takes special moving X-rays (called “cinegrams”) of the heart and blood vessels. The procedure can be performed in any age.
Because pediatric cardiac catheterization requires a child to lie very still, and there is discomfort associated with insertion of the catheters, the procedure is done with sedation or anesthesia. The Cardiac Center anesthesiologists work with our pediatric cardiac catheterization doctors every day, and will make sure that your child is comfortable throughout the procedure.
Diagnostic cardiac catheterization is a test that’s done to determine the exact details of your child’s heart and how it functions. It’s sometimes performed in preparation for heart surgery or a catheter-based treatment (such as dilating a blood vessel or closing a hole in the heart) or to determine if more treatment is needed at all.
The pediatric cardiologist guides one or more catheters through the blood vessels and into the heart to take measurements of blood flow, pressure and oxygen levels in the heart chambers and large vessels close to the heart.
This helps the cardiologist to determine how the heart is functioning and how much blood is flowing through normal and abnormal connections. The catheter is guided using a special X-ray method called “fluoroscopy” (and occasionally ultrasound) to help the doctor figure out where the catheter should go. And moving pictures of the heart chambers and blood vessels are usually taken using a special X-ray dye known as “contrast,” which is injected through the catheter.
Depending on your child’s specific heart problem, it may be treatable during cardiac catheterization, making open-heart surgery unnecessary. Our specialists at the Nemours Cardiac Center have extensive experience in the nonsurgical treatment of heart disease.
An “interventional catheterization” (sometimes called “therapeutic catheterization”) can be used to:
- close abnormal holes in the heart
- open narrow blood vessels and valves
- work together with traditional open-heart surgery to treat complex cases
An interventional catheterization is performed like diagnostic catheterization (see description above) and allows the pediatric cardiologist to perform procedures such as:
- closure of abnormal connections inside and outside the heart.
- closure of holes between upper or lower chambers of the heart (such as single or multiple atrial septal defects or muscular ventricular septal defects) using a specially-designed plug that comes in various sizes, depending on the size of the hole or the abnormal connection. These are permanent implants that don’t have to be exchanged when a child grows — they just heal into the body and become part of the heart or the blood vessels.
- closing off an abnormal blood vessel between the aorta and lung artery with a small coil or a special plug (as in patent ductus arteriosus, or “PDA”).
- balloon angioplasty (in which a small balloon is inflated inside the blood vessel to stretch narrowed arteries and veins).
- balloon valvuloplasty (using a small balloon to stretch the opening of heart valves).
- stent implantation (in which a small metal mesh tube is placed within a blood vessel to keep it open) — if the stent is implanted early in life, it will have to be enlarged to keep up with growth, which is a very straightforward procedure.
In some complex cases, our heart surgeons, cardiologists and their teams work together to perform combined surgery and interventional catheterization procedures to achieve better results with less risk. By offering this kind of treatment option (typically called a “hybrid procedure”), we’re improving the outlook for scores of children with complicated heart disease. And we’re proud to be one of only a handful of centers in the United States where these combination treatment capabilities are available.
The operating room in the Nemours Cardiac Center (used exclusively for pediatric heart surgery) is located right next to our cardiac catheterization suite, which is fully equipped to perform hybrid procedures. With these facilities, our pediatric cardiology team can provide the best treatment for your child in a timely manner, whether it’s surgery, interventional cardiac catheterization or both.
Pediatric cardiac catheterization is done under sedation with local anesthesia or under general anesthesia, depending on your child’s age and condition.
The Nemours Cardiac Center has its own pediatric anesthesiologists, with the experience and skills required to provide specialized anesthesia for children with heart problems, from the minor to the very complex. Our pediatric cardiac anesthesiologists, who work only with heart patients in the Cardiac Center, provide anesthesia or deep sedation for diagnostic, interventional or hybrid cardiac catheterization procedures.
Anesthesia care begins prior to the procedure when you meet your child’s anesthesiologist, who will prescribe an oral medication to relax your child and ease his or her separation from you into the catheterization suite. Most children receive anesthesia by a mask rather than an IV, so needles can be avoided until your child is under anesthesia. For catheterization, we use relatively short-acting anesthetics with few side effects. Some older patients prefer to receive sedation rather than anesthesia for their catheterization procedures — our anesthesiologists are there to make sure they’re comfortable as well.
Because the anesthesiologists at the Nemours Cardiac Center often care for patients more than once, we get to know your child and your family, and we’re able to determine which medications and strategies work best for your child’s individual needs. We find that parents are often reassured to see a trusted familiar face as their child makes a trip to the catheterization suite.
After catheterization, your child will go to our recovery unit for special monitoring before returning to your private room. You may be at your child’s recovery area bedside at all times. In many instances, your child may be discharged later the same day or the next morning. Typically, children are back to their normal selves within a few hours. And catheter-based treatments do not require extended recovery periods. Children can usually return to school after three days.
Although our team may know your child’s heart, you know your child best. That’s why we strive to always offer “family-centered care.” That means we want you to be an active participant in the decision-making and we want to make sure you understand exactly what’s going on at all times.
Family-centered care means we’ll take the time to:
- explain the diagnosis and treatment in understandable terms
- present all of the options
- invite your family’s input for creating the right treatment plan for your child
- encourage you to stay by your child’s side as much as possible
- make sure your questions are answered and your fears and concerns are addressed
Throughout your family’s journey with your child’s heart condition, know that at the Nemours Cardiac Center we do whatever it takes to give your child the very best, most compassionate care possible. We’ll be there to help your child and your family every step of the way.
Learn More About Cardiac Catheterization in Children
So you’ll understand what will happen during your child’s cardiac catheterization, your doctor may give you a code to watch a video (produced by EmmiKids, an interactive Web-based tool that makes complex medical information easy to understand — even for our youngest patients).
You can also check out this Cardiac Catheterization article from Nemours’ experts at KidsHealth.org. Read KidsHealth Article »
Also, learn what to expect for your child’s procedure or hospital stay. Go to Patient Education »