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Heart Catheterization

General

Many children come to Riley Hospital for Children at Indiana University Health for a heart catheterization. Our goal 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 want to make you as comfortable and as informed as possible.

You and your child need to know what to expect about his or her heart catheterization before coming to the hospital. This information is to help parents understand the procedure and hospitalization. It will also help you to answer your child's questions as they arise. If your questions are answered about the procedure, you may feel more comfortable about the hospitalization. Your calm attitude and confidence will then be conveyed to your child.

Riley Hospital for Children at IU Health has many services and professionals to assist parents. Our social work staff is also available for supportive assistance and counseling. A chaplain is available upon request. Our chapel is located on the first floor of the hospital. A pediatric cath lab registered nurse is available to answer questions about the catheterization and to talk with your child about what to expect. These are only a few of our services. Please discuss any concerns or requests with your child’s nurse.

Riley at IU Health allows parents 24-hour visitation. Most children find being separated from their parents is a very frightening experience. We encourage you to remain here with your child during the hospitalization.

Heart Catheterization Details

This section is a detailed discussion about the events that surround a heart catheterization. Please share as much of this information with your child as you feel is appropriate.

The week before your child's heart catheterization, a cath lab nurse will call to give you instructions and answer your questions. You will be given very important information regarding the time your child needs to stop eating and drinking before their procedure and what time you need to be at Riley at IU Health on the day of the procedure.

Pre-cath testing such as chest X-ray, EKG or echocardiogram may be required. These tests can usually be done in the morning on the day of the catheterization. If you need to arrive early for testing, the nurses will discuss this when they speak with you.

The Day of the Catheterization

On the day of your child’s heart catheterization, you will need to register in the Emergency Department or the Main Admitting Office located in Riley Hospital Room 1940. You will then be directed to the Cardiac Cath Lab. A cath lab nurse will obtain your child’s vital signs and do an admission assessment. The nurse will talk to you in detail about the catheterization, how long it takes, and where you may wait during the test. You will also meet with the cardiologist and anesthesiologist. About 20 minutes before the start of the procedure, your child may receive an oral medication to help him or her relax. Once the medication has taken effect, the nurses will take your child to the catheterization room to start the procedure. At this time, you will be given directions to the waiting area in the Riley Heart Center. Please let the nurse know if you plan to wait elsewhere, so that your child’s doctor will be able to find you when the procedure is finished.

In the catheterization room, precautions are taken to prevent infection. The nurses and doctors wear special clothes, hats and masks. Your child will be asked to lie flat on his or her back on a procedure table. Electrodes (special stickers) will be placed on his or her chest, arms and legs to monitor heart rate and rhythm at all times. A probe (it looks like a bandage), which assists us in monitoring oxygen levels, will be placed on your child’s finger or toe. An IV is inserted and medicine is given to assist your child to sleep during the catheterization. Once asleep, your child will not feel or hear anything during the procedure. Often, patients may breathe in a medical gas to fall asleep and their IV is inserted after they are asleep. The anesthesiologist will discuss this with you and your child before your child is taken to the procedure room. Some of our young adult patients may have their cardiac cath done under conscious sedation. In these cases, the physician, parent and child make this decision together prior to going back to the procedure room.

Next, the cardiologist will decide the best blood vessels to use for the procedure. The skin over the site is cleaned with an antiseptic soap. Your son or daughter will then be covered with a sterile drape from head to toes, except for an opening over the vessel entry site. There is an X-ray camera suspended over your child, but it never actually touches him or her.

While your child is sleeping, the cardiologist will access a vein and/or an artery and insert a sheath (a sheath is similar to a large IV). A catheter is inserted through the sheath. When the catheter is advanced to the heart, the cardiologist can begin to obtain small blood samples and record pressure measurements from different areas of the heart. The doctor will also take pictures of the heart. As soon as the test is completed, the catheter and sheath will be removed and a nurse will apply pressure tightly over the vessel access site to prevent bleeding. After applying pressure for at least 10-15 minutes, and when bleeding has stopped, a tight bandage is applied. There is some risk of bleeding for several hours after the catheterization; therefore, your child will be asked to lie quietly in bed with his or her legs kept straight. He or she will not be allowed out of bed for at least four hours after the procedure and will continue to recover after being transported to a room in the Riley Heart Center where you may be with him or her.

While your child is on bed rest, the nurse in the Riley Heart Center will check your child’s temperature, heart rate, blood pressure and oxygen level. The nurse will also check the dressing and pulses in the feet frequently. Many children want to sleep all afternoon as a result of the anesthesia medications. If your child does not feel sick to his or her stomach, then he or she will be allowed to have a drink of water or clear juice as soon as he or she is thirsty. If this is tolerated and your child feels hungry, regular food will follow. Pain medication will be given should your child have any discomfort.

The doctor who catheterized your child will speak with you right after the procedure and/or later that evening.

Discharge

Your child may feel tired immediately after the procedure but then more “like themselves” within a few hours. Some children will be able to go home the evening of their heart catheterization; other children will stay overnight for observation and be discharged the next morning. The length of time that your child needs to stay in the hospital depends upon his or her heart disease, the reason for the heart catheterization and how well your child is doing.

The cardiologist or nurse will remove the bandage from the entry site and examine the site where the sheaths were removed. A cardiology doctor will examine your child, speak with you and write the discharge papers so that you may take your child home. Your child will be able to resume light activity following discharge, and typically, usual activity is allowed in one to two days. The doctor or nurse will advise you if further activity restrictions are ordered. After 48 hours, your child may take a tub bath. The entry site may appear bruised for up to 7-14 days. Prior to discharge, the Riley Heart Center nurse will discuss home care instructions with you and your child. After discharge, a cath lab nurse will call to follow up with you and your child. You may also call your doctor with any questions or concerns.

Interventional Catheterizations

Although many heart catheterizations are done to gain more accurate information about the heart (diagnostic), heart caths are also done to treat an abnormality. These are called interventional caths. If your child is scheduled for this type of treatment, you will receive an additional sheet with a diagram describing the procedure in your packet of information.

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