Many children come to Riley Hospital for Children at Indiana University Health for a heart catheterization. Our goal at Riley at IU Health is to provide your child with the best care possible. The hospital has a large staff with extensive facilities to assist the doctor in meeting your child's needs. We know that this may be a new experience and you may be anxious about what to expect. We wish to make you as comfortable and as informed as possible.
It is our belief that your child will benefit from an explanation of his/her heart catheterization before coming into the hospital. This web page is prepared for parents to help explain the hospitalization and to answer your child's questions as they arise. We also find that if the parents' questions are answered about the procedure, they feel more comfortable about the hospitalization and this calm attitude is conveyed to their child.
Riley at IU Health has 24-hour visitation for parents. For most children, one of the worst parts about staying in the hospital is separation from their parents. We, therefore, encourage you to remain here with your child during the hospitalization if possible.
Riley at IU Health has many services and professionals to assist parents. There is a Social Service staff that is available for supportive assistance and counseling. There is a 24-hour chaplaincy program and a chapel located on the first floor of the hospital. A special nurse is also available to answer questions about the catheterization and to talk with your child about what to expect.
The Heart Catheterization
This section is a detailed discussion about the events that surround a heart catheterization. This section is for your information, and will allow you to choose the areas to discuss with your child.
The week prior to your child's heart catheterization, a nurse will call to give you instructions and answer questions. You will be given information regarding the time your child needs to stop eating and drinking the night before, and the time you need to be at Riley at IU Health on the day of the heart catheterization. If you have questions, call 317.274.8906 and the nurse can answer them for you, or relay a message to the doctor for you.
If your child is a new patient to the cardiologist, or if it has been longer than six months since the last time you saw the cardiologist, you will be asked to come the day before the heart catheterization, for "pre-cath" testing. This testing will be done on an outpatient basis; that is, you will come in the morning and leave in the afternoon, once they are all completed.
You will report to the Riley Outpatient Center at IU Health Registration Office, near the front entrance of the hospital, the morning of the "pre-cath" testing. After this, you and your child will be directed to the Cardio-pulmonary Department to have an ECG (EKG) and perhaps an echocardiogram. Your child will also have a chest x-ray and blood work drawn, while here.
If your child is 1 1/2 years or older, a quick dental check may also be performed since severe dental carries (cavities) can increase the risk of infection during the catheterization. You will see your child's cardiologist and sign the consent for the heart catheterization procedure. You will also be directed to the Day Surgery Department where you will meet the anesthesiologist and sign consent forms for the anesthesia as well.
The Day of Catheterization
The morning of your child's heart catheterization, you report to the In-Patient Registration Office, and register for the day. You will then be directed to the cardiac catheterization lab. A nurse there will take your child's vital signs and do an admission assessment on her/him. She will take the time to talk to you in detail about the catheterization test, how long it takes, and where you will wait during the test. (Most parents wait in the Main Lobby or Atrium near the glass elevators). About 30 minutes before the procedure, most children will receive an oral medication to help them relax. Once the medication has taken effect, the nurses will take your child to the catheterization area to start the procedure. The entire catheterization procedure may take 2-4 hours to complete.
In the catheterization room sterile technique is observed. The nurses and doctors wear blue clothes, hats, and masks. Once in the catheterization room, your child will be asked to lie flat on his/her back on an X-ray table. Electrodes will be attached to his/her arms and legs so that his/her heart rate and rhythm can be transmitted with every heartbeat. The anesthesiologist will start an I.V. in one arm and add some medication that will allow your child to nap during the catheterization. Your child's groin area will be cleansed with a special soap that is warm and brown. He/she will then be covered with a sterile drape from chin to toes, except for an opening over each groin. There is an x-ray camera suspended over your child, but it never actually touches him/her. While your child is sleeping, the cardiologist will enter a vein and/or artery in the groin area with a catheter (a soft plastic or rubber tube that looks like a spaghetti noodle). When the catheter is advanced to the heart, the cardiologist can begin to take small blood samples and pressure measurements from different areas of the heart. During the catheterization, he will also take pictures of the heart with the x-ray camera.
As soon as the test is completed, the catheter will be removed and a nurse will apply pressure tightly over the groin to prevent bleeding. After she presses for ten to fifteen minutes, a tight bandage is applied. There is some risk of bleeding for several hours after the catheterization so your child will be asked to lie quietly in bed with the leg out straight. He/she will not be allowed out of the bed for approximately 6-8 hours following the catheterization. While your child is on bedrest, his/her nurse will be monitoring vital signs. She will also check the dressing and pulses in his/her feet frequently. Many children want to sleep all afternoon as a result of the anesthesia medications. If not sick to his/her stomach, your child will be allowed to have a drink of water or clear juice as soon as he/she is thirsty. If your child tolerates juice during the afternoon and feels hungry at supper, he/she will be allowed a regular meal.
The doctor who performed the cardiac catheterization will talk with you further, either right after the procedure or later that evening. He/she will be able to give you more information after the movie pictures of the heart are developed.