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Cardiac catheter

Why perform a catheterisation?

Cardiac catheterisation helps your cardiologist gain additional information to fully evaluate and/or treat your child's heart condition. It is a test that shows how the heart chambers, valves and vessels are formed and how they are functioning.

Cardiac catheterisation provides your cardiologist, and surgeon, with detailed information not available through other testing.

 

What is a heart catheterisation?

It is similar to a surgical procedure, although there are usually no incisions or stitches. To help prevent infection staff wear sterile gowns, hats and masks and the patient is covered with a sterile drape. The procedure is usually performed under general anaesthetic and a local anaesthetic is also used to numb the skin.

A thin flexible tube, known as a catheter, is inserted into a vein and/or artery, usually in the groin though occasionally to one of the neck veins.

Once the catheter is in the blood-vessel, the cardiologist uses X-ray screening to guide it into the different areas of the heart. The movement of the catheter within the heart is not painful or uncomfortable. While the catheter is in the heart, several procedures are performed:

  • blood-pressures in different heart-chambers and blood-vessels are recorded;
  • the oxygen content of the blood in each heart-chamber is evaluated;
  • dye/contrast is injected through the catheter;
  • angiograms (X-ray movies of the dye/contrast movement) are filmed so details of the cardiac problem can be recorded.

Most catheter procedures last between one and two hours, though your cardiologist will discuss if the procedure is more complex. Afterwards there may be a bandage/dressing applied to the catheter insertion site.

Before your child is discharged, the cardiologist will review the preliminary findings with you. Later, this data and any other investigations may be further reviewed at the Joint Cardiac Conference. This is a weekly meeting of cardiologists, surgeons and other members of the team make recommendations about your child's future care.

 

What you should know

Pre- admission clinic:

It is important that you attend this for the following reasons:

  • To meet members of the medical and nursing team who will be caring for you/your child on admission
  • To make sure you/your child is well enough to undergo the intended procedure.
  • To familiarise you/your child to the hospital, the ward and what to expect on admission.
  • To share with you the practical aspects of your/your child's admission, such as when you/your child should eat and drink or any adjustments to existing medication. You will also be able to discuss how best to prepare your child for the procedure.
  • To have preliminary tests including ECG, chest X-ray and blood tests as deemed necessary by your cardiologist.
  • We believe attendance at the pre-admission clinic helps you prepare for your tests and reduces the length of hospital stay.
  • We will try to facilitate accommodation requests as best we can though priority is given to families of acutely unwell and long stay patients.

 The week of the procedure:

If your child has a fever, cold, flu, severe nappy rash or exposure to any contagious disease during the week prior to the procedure, please check with your child's cardiologist or the cardiac nurse specialist as soon as possiblebeforecoming to the hospital.

It is important to discuss with your cardiologist the timing of any medications your child is taking.

The day before the procedure:

Your child should eat a good meal, have a bedtime snack and get a good night's sleep.

Your child maynoteat or drink anything, including water, after the time given to you by the nursing or medical team.

 The morning of the catheterisation:

Do not give your child any medications, prescription or over-the-counter, unless your cardiologist has previously given approval. When you arrive at the hospital, please go to ward 32.

For more information about the ward, please click here

Prior to the cardiac catheter procedure, your child will receive a physical examination. A chest X-ray, ECG and echocardiogram may also be performed if these have not been already been completed in a pre-admission clinic. Your anaesthetist will usually see you on the day of the procedure.

The nurse will take you to the catheter lab on level 4 where the procedure will be performed. Due to space constraints within the anaesthetic room we request that only one parent accompanies the child and nurse.

Before and during the catheterisation

Before the procedure, the cardiologist, anaesthetist and nurse will discuss any remaining questions you may have and you will be asked to sign a consent form. This is standard in any surgical or invasive procedure.

A premedication may be used in order to keep your child calm; your anaesthetist will discuss whether this is necessary and/or appropriate. The type of anaesthesia/sedation used will depend on the procedure being performed as well as other factors such as your child's age, ability to lie still, and any associated medical problems.

Following the catheterisation

You will usually be asked to collect your child from the recovery area with one of the ward nurses, so you will see your child soon after they recover from the anaesthetic. Please be aware your child may be drowsy and/or may sleep for a few hours.

During recovery, your child will be placed on a heart monitor until completely awake. A nurse will frequently check vital signs (temperature, pulse, breathing, blood pressure), circulation, the heart monitor and the catheter insertion site(s).

Once fully awake, your child may drink clear liquids and juices, provided by the nurse. If nausea or vomiting occurs, discontinue the liquids until the symptoms subside.

Before you leave, the cardiologist will discuss the preliminary results and recommend an initial treatment plan.  If your child is likely to require surgery, your cardiologist will talk to you about this and agree the next steps.

 

Taking Your Child Home

You will be given information on how to care for the catheter site while it heals and you will be given a copy of the immediate discharge summary in case you need to seek medical advice.  Please show this to any nurse or doctor if you need to seek medical advice soon after discharge from hospital.

You may take, or give your child, paracetamol or Calpol for pain or fever, if needed.

You/your child should refrain from bathing or swimming for three days after the test. Showers or sponge baths are permitted, but the entry site(s) should be kept as dry as possible.

Strenuous exercise or participation in sports should also be avoided for three days after the test. Usually normal activity can be resumed three days thereafter.

 

When to call for help
 

It is unlikely that any problems will arise after the catheterisation, but if you observe any of the following, call your cardiologist.

  • Bleeding from the catheter site is abnormal and can usually be stopped by firm pressure on the site. Apply pressure for 10-15 minutes and notify Ward 32 immediately. If bleeding does not stop, take your child to the nearest hospital emergency room for treatment.
  • A small amount of bruising and minimal discomfort at the catheter site is normal and will go away in a few days. Swelling, redness or pus at the insertion site, severe discomfort or significant pain upon walking should be reported to your child's cardiologist or cardiac nurse specialist.
  • A slight fever is common after catheter procedures, but should not last longer than 24 hours. If it continues beyond that period, please discuss with ward 32, cardiac nurse specialist or cardiologist. 

Our staff will do everything we can to answer your questions and to make your child's experience as comfortable as possible. If you have additional questions about your child's procedure, please speak with our cardiac nurse specialist on 0117 342 8286 or contact your child's cardiologist.