What to Expect
The cardiac catheterization laboratory is where doctors can diagnose and treat heart conditions using catheters instead of surgery.
Many different procedures can be safely done in the catheterization lab instead of an operating room.
What are catheters?
Catheters are spaghetti-like plastic tubes used to insert special equipment to diagnose or treat a heart problem.
The many different sizes and shapes of catheters allow the heart doctor (cardiologist) to perform a variety of tasks.
Why are catheters used?
For diagnosis, catheters may be used to measure pressure in the heart. Catheters can be used to insert special dyes that enable doctors to take pictures of the inside of the heart (called angiography).
These diagnostic procedures help the doctor plan your child's care by providing information that an electrocardiogram (ECG) may not be able to show.
Often, catheters are used to treat common heart defects. This use is called interventional or therapeutic catheterization.
Catheters may be used to open up narrowed blood vessels and heart valves, close holes in the wall between heart chambers (septum) and close abnormal blood vessels.
Very specialized catheters are used to study and treat heart rhythms (electrophysiology). They give doctors information they can't get by looking at an electrocardiogram.
They also can be used to treat some rhythm problems through a procedure called radiofrequency ablation.
When do we arrive for the appointment?
The day before a catheterization procedure, a Seattle Children's staff member will call to tell you what time to arrive at the hospital.
Also, you will be given feeding instructions for your child, including a specific time to stop giving them anything to eat or drink. It is important for your child to have an empty stomach before the catheterization procedure.
Where do we go for the appointment?
Please check in for cardiac catheterization procedures at the Surgery Center located on level 6 of the hospital. (Directions to the hospital.)
What happens before the cardiac catheterization procedure?
Many things need to happen before the procedure to make it as safe as possible. We will ask general health questions and your child will have a brief physical exam that includes weight and height measurements.
You will meet many people involved in caring for your child before and during the catheterization:
- A cardiac anesthesiologist will meet you and talk about how your child will be kept comfortable during the procedure. The anesthesiologist will be in charge of getting your child to sleep and keeping them from feeling any pain during the procedure.
- You also will meet the doctor who will be performing the procedure and inserting your child's catheter. The doctor and a nurse practitioner will explain the procedure, the risks and the benefits of the procedure to you before it starts.
Then you and your child may be brought into the induction area. In the induction area, your child will be given a mild sedative, and then they will be brought into the catheterization laboratory.
You may be asked if you want to come into the catheterization lab with your child to be present as they fall asleep.
You will be given a pager so you can be paged with updates and notified when the catheterization is over.
What happens during the procedure?
After your child is asleep, the cardiologist starts the catheterization.
Most of the time, the doctor makes a small hole at the top of the leg in order to insert the catheter into the blood vessels. A needle is placed in the vein or artery at the top of the leg and then replaced with a plastic tube called a sheath.
The sheath lets the doctor put the catheter in safely and prevents bleeding from the needle puncture.
From there, the small catheter can be advanced into the chambers of the heart. Sometimes other blood vessels are used, including one on the neck.
During the catheterization, having a pager with you means you can wait anywhere in the hospital that is comfortable for you. A nice place to wait is the Family Resource Center on level 7 in the River zone.
What happens after the procedure?
With the procedure completed, all the catheters are removed. A large bandage is placed over the small entry holes.
Your child must remain flat and still and keep their leg straight for 4 to 6 hours after the procedure. Your child will spend the first hour in the main recovery room waking up from the anesthesia.
If your child is expected to go home that day, they will spend 3 to 4 hours in another recovery room where you can be at their side. Your child can watch television or movies, play video games, eat or relax and read, but they must remain flat, still and keep their leg straight the whole time. If your child is expected to stay in the hospital, your provider will talk to you about what to expect, including when you can be with your child after the procedure.
Before you go home, we will tell you about signs to look out for after the procedure that may mean your child should return to the hospital. A nurse will explain the discharge instructions in detail, including when your child can be active again.
How long does it take?
Most catheter procedures take at least 2 hours.
Electrophysiology procedures can last 5 hours or more.
When can my child go home?
In most cases, your child can go home after spending 4 to 5 hours in recovery. Your child may be admitted to our hospital to spend the night.
Often, children can go back to normal activities within several days.
Rather than a large incision on the chest from open heart surgery, children with cardiac catheterization procedures have only a tiny cut where the catheter was inserted.
Contact the Heart Center at 206-987-2015 for a referral, a second opinion or more information.