Interventional Cardiac Catheterization
Cardiac catheterization procedures have been an important part in caring for children with congenital heart defects at the Heart Center at Texas Children’s Hospital. A cardiac catheterization procedure consists of using a small artery or vein in the child’s leg and placing a catheter into this artery or vein. The catheter is similar to a long straw, and it is advanced through the artery or vein into the heart. Once inside the heart, the catheter is used to measure pressures in the heart chambers, sample the amount of oxygen in the blood, and inject a special dye to take pictures of the heart.
Initially, cardiac catheterization was used as a diagnostic tool, to define a child’s exact heart defects and determine the hemodynamic information. For many years, every child who had a heart defect had a cardiac catheterization performed. Over the last ten years, two exciting medical advances have changed the focus of the cardiac catheterization laboratory:
- Advances in echocardiography to determine heart defects using ultrasound
- Technology improvements in cardiac catheterization equipment, including catheters, balloons, stents, and occlusion devices
With these advances, cardiac catheterization procedures are used less often to diagnose a child’s heart defects, and more frequently to perform an interventional procedure. An interventional procedure is performed to correct a child’s heart defect, often instead of the child having to undergo heart surgery. Many of these heart problems are present since birth, other problems develop after heart surgery.
Many of the interventional procedures used to correct children’s heart problems have been developed in the cardiac catheterization laboratories at Texas Children’s. Special catheters have balloons that can be inflated after the catheter has been carefully positioned in the heart; the balloon can open a heart valve that is narrowed and not opening. A stent, a wire mesh type of scaffolding, can be placed on a balloon and when the balloon is inflated, the stent expands against a narrowed blood vessel and helps hold open the vessel. Several devices are shaped like an “umbrella”, and they are used to close holes in a child’s heart. Some children are born with extra blood vessels connecting the aorta to the pulmonary arteries; special “plugs” shaped like coil springs are used to close these unnecessary vessels.
For children who have heart rhythm problems, a special catheterization laboratory is dedicated to providing state-of-the-art treatment. Some children have extra fibers in the heart that can cause very rapid heart rates; special catheters have been developed to either “burn” or “freeze” these fibers. Once the fiber has been treated, the heart rate is normal and the child can return to normal activities. Other children have a heart rate that is too slow, and they need to have a pacemaker placed to maintain a steady heart rate.
In 2003, pediatric cardiologists in the Cardiac Catheterization Laboratories at Texas Children’s performed nearly 1,000 cardiac catheterization procedures. These procedures were performed on children ranging in age from several hours old and weighing only four pounds, to full-grown teenagers and a few young adults. New catheters and devices are being evaluated every day, with the hope of developing even more advanced care for children with heart problems.
- Himesh Vyas, M.D.
- Cheryl Mendoza, RN (Nurse Coordinator)
- Linda Drake, RN
Click here for more information about advanced training opportunities in Pediatric Interventional Cardiac Catheterization.