Cardiac Catheterization Procedure

What is cardiac catheterization?

Cardiac catheterization, commonly referred to as heart catheterization or a heart cath, is a minimally-invasive procedure that allows specialized heart doctors called interventional cardiologists to view the heart and treat heart problems, including congenital heart defects. Heart catheterizations take place in a specialized procedure room called a cardiac cath lab.

How does cardiac catheterization work?

At Children’s Hospital Colorado, our Cardiac Catheterization Program performs heart catheterization procedures for pediatric patients as young as 3 days old all the way through adulthood for patients with adult congenital heart disease.

During a heart cath study, doctors insert a catheter (a long, hollow tube) into the blood vessels of the groin area or neck and navigate through the blood vessels to the heart. They then inject contrast dye through the catheter and use X-ray imaging to take pictures as the dye moves through the heart. This allows the cardiologist to watch blood flow through the heart to find any abnormalities in the heart muscle, heart valves and vessels. There are two types of heart catheterization: diagnostic catheterization and interventional catheterization.

What is a diagnostic heart catheterization?

Doctors use diagnostic heart caths to examine the heart, its blood vessels and valves, and how blood flows through the heart. This gives us a better understanding of how each heart works. Diagnostic heart catheterization usually includes three steps:

1. Recording blood pressures in different chambers of the heart and blood vessels
2. Evaluating the blood’s oxygen content in each chamber of the heart
3. Performing an angiogram (a test that uses X-rays to take pictures of the heart and its blood vessels)

What is interventional heart catheterization?

Doctors use interventional heart caths to fix defects or abnormalities in the heart. Interventional cardiologists will first perform most of the diagnostic techniques listed above, and then continue with corrective procedures. Interventional procedures may include:

• Balloon valvoplasty: using a catheter with a balloon at the tip that is inflated to open a narrowed heart valve
• Balloon angioplasty: using a catheter with a balloon at the tip that is inflated to open narrowed blood vessels
• Stent placement: inserting a stent (a small mesh tube) on a catheter with a balloon at the tip; the stent expands with the inflation of the balloon and is then able to support narrow blood vessels after the balloon is removed
• Arrhythmia ablation: using a catheter to remove tissue that causes an arrhythmia (an irregular heartbeat); many times this is done together with electrophysiology studies
• Septal closures: using small devices passed through a catheter to close holes within the heart wall
• Heart valve placement: placing an artificial valve in the heart by collapsing it and passing it through a catheter; the valve is then reformed out of the catheter within the heart

Conditions we treat with cardiac catheterization

At Children’s Colorado, we use interventional heart catheterization to treat many congenital heart conditions. These include:

• Aortic valve stenosis
• Atrial septal defect (ASD)
• Coarctation of the aorta
• Patent ductus arteriosus (PDA)
• Pulmonary arteriovenous malformations
• Pulmonary regurgitation
• Pulmonary valve stenosis
• Tetralogy of Fallot (ToF)

Why choose Children’s Colorado for cardiac catheterization procedures

Caregivers in Children’s Colorado’s Cardiac Catheterization Program have extensive experience diagnosing and treating congenital heart defects. Our Program is one of the highest-volume cardiac catheterization centers in the nation, performing over 900 heart caths and hundreds of complex interventional heart caths for infants, kids, teens and adults every year. This means we have more experience with a wider variety of heart defects than most other hospitals both locally and nationally. Our volumes and patient outcomes put Children’s Colorado’s Heart Institute among the best of the best.

See why our outcomes make us one of the top heart hospitals

Equipped with a new, state-of-the-art, radiation-reducing catheterization system, our team performs a host of innovative, minimally invasive procedures. Additionally, our nationally-ranked Heart Institute has the only accredited adult congenital heart program in Colorado and many of the surrounding states, ensuring that our heart patients receive complete and comprehensive care throughout their entire lives.

What to expect before cardiac catheterization

Patients and families can arrange to meet your interventional cardiologist and their team for an outpatient appointment before scheduling the procedure. The care team will explain the procedure completely and answer any questions. In some cases, we will provide a three-dimensional (3D) heart model to help explain your condition and procedure.

The day before the procedure, a nurse will call you to confirm what time to arrive and when the heart cath will start. The nurse will provide important instructions about when the patient should stop eating and drinking before the procedure. If the patient’s stomach is not empty at the time of the heart cath, stomach contents can come up and enter the lungs (called aspiration) and may cause serious problems.

How to get ready for a cardiac catheterization

Use the following tips for how to prepare and what to bring to a heart cath at Children’s Colorado:

Babies and toddlers

• Pack your child’s favorite blanket, stuffed animal, toy or pacifier to help comfort them.
• Bring a familiar bottle and nipple for after the procedure.

Young children

• Pack your child’s favorite toys and books to help comfort them before and after the procedure.

Adolescents, teens and adults

• Pack a book, tablet or phone that is easy to use while lying down.
• Wear comfortable clothing.
• Remove all make up, including nail polish from fingers and toes.
• Trim or shave any pubic hair. (Bandages from the procedure may pull on the hair. The care team will shave the area before starting the procedure, if necessary.)

The day of cardiac catheterization

After you have checked in, a member of our care team will explain all of the planned tests and catheterization procedures. Tests may include blood and urine tests and an electrocardiogram (EKG), chest X-ray or echocardiogram (ECHO). Feel free to ask questions at any time. Child life specialists will be available to help children and teens understand and prepare for the procedure.

What to expect during cardiac catheterization

In the cath lab, the care team will move the patient onto a special bed and cover them with warm blankets. Our cardiac nurses will start an IV and hook up medical devices to monitor the patient’s blood pressure, oxygen, heart rate and other vital signs.

At this time, a cardiac anesthesiologist will give the patient anesthesia or sedative medication to keep them comfortable and still throughout the procedure. The cardiac anesthesiologist will closely monitor the patient and ensure they remain comfortable during the procedure. Although most cardiac cath procedures are performed under general anesthesia, in some circumstances, sedation along with a local anesthetic may be more appropriate.

Once the patient is asleep, the care team will cover their entire body with a sterile drape. Doctors will clean the area where they will insert the catheter (typically the groin but sometimes the neck) and numb the area with medicine.

The cardiologist will then insert the catheter into a vein or artery and guide it to the areas of the heart they want to see or repair. Our nurses will update the patient’s parents or caregiver throughout the procedure.

How long does cardiac catheterization take?

A diagnostic heart cath typically takes 1 to 2 hours. An interventional heart cath may take 1 to 4 hours, depending on what procedures or corrections the patient needs.

What to expect after a heart catheterization

After the heart catheterization, we will bring the patient to a recovery area where they can rest. Patients should remain lying down for several hours to help the catheter access point heal. Nurses will be available to check on the patient throughout the recovery time in the hospital.

There may be some discomfort around the catheter access point in the groin or neck. Our care team will help keep the patient comfortable.

Most patients can leave the hospital within 24 hours after a cardiac catheterization. Some patients with more serious heart conditions or those who are hospitalized will need to remain longer.

How long does it take to recover after a heart cath?

Depending on the severity of the patient’s condition and procedures, the full recovery period for a heart cath can take several days to several weeks. Your doctor will provide instructions and any restrictions for your recovery.

Take a tour of our Cath Lab

Knowing what to expect can help patients and family members feel more relaxed on the day of a cardiac catheterization. At Children’s Colorado’s Heart Institute, we offer pre-procedure tours for patients ages 3 and older led by child life specialists, who are specially trained to support children through medical procedures. These specialists will make every effort to address and soothe any fears your child may have.

The tour takes about one hour. During that time, you will see a cath lab, learn your way around the hospital and talk about what will happen on the day of the procedure.

We offer cath lab tours on Fridays between 10 a.m. and 2 p.m. To make a reservation, please call 720-777-2530 and provide the following information:

• Your name
• Patient name
• Patient date of birth
• Type and date of the cardiac procedure
• Two date and time options for the tour
• Number of people who will attend the tour (please limit to immediate family members, and note that siblings will not be allowed during any visitor restriction periods like flu season)
• A phone number where we can reach you during business hours

If you need to cancel or reschedule your tour, please do so as soon as possible by calling 720-777-2530.