Information Leaflet for parents/carersDiagnostic Cardiac Catheterisation Revised April 2007
What is cardiac catheterisation, and why is itneeded?Cardiac catheterisation is carried out to getinformation about heart defects. This informationcannot be obtained by other tests. Information isobtained about:• blood pressure inside the chambers of the heart• how well the pumping chambers and valves are working• the exact severity and position of any heart defectsIn some children more tests are needed. The finaldecision on catheterisation will usually be taken afterdiscussions between all the paediatric cardiologistsand cardiac surgeons. These meetings take placeregularly.What are the benefits of catheterisation?The information we get from the catheter is used towork out the best treatment for your child. Thismight mean:• no change in the treatment• starting or changing medication• interventional cardiac catheterisation• cardiac surgery
What does cardiac catheterisation involve?Children are usually given a general anaesthetic for acardiac catheterisation. Sometimes, a sedative andlocal anaesthetic may be used. For furtherinformation about your childs anaesthetic please askthe nursing staff for a copy of the “Your childsgeneral anaesthetic” patient information leaflet.Copies are also available in the Child and FamilyInformation Centre.The catheters are normally inserted through thearteries and/or veins in the leg. Sometimes they areinserted into the artery and/or vein in the arm, theside of the neck, or under the collarbone. Usually, aneedle puncture is all that is necessary. On rareoccasions, however, a small cut is needed to find asuitable blood vessel.X–rays are used to guide the passage of the catheterthrough to the heart. A special solution of fluid(called contrast) is injected through the catheter to letus take X–ray pictures of the heart and lung arteries.Special medications or gases may also be given so thattheir effects on heart pressures can be measured. Atransœsophageal echocardiogram is sometimesperformed at the same time as the cardiac catheter toget more information. This is done by passing aspecial echo probe down the back of the throat intothe oesophagus (food pipe).
What is Interventional CardiacCatheterisation?Interventional catheters are used to treat some heartconditions that used to need surgery. Interventionalcardiac catheterisation can be used to:• stretch narrow vessels or valves using a balloon catheter• insert stents, to keep narrow vessels open• close holes, by passing a special device through the catheterIt is possible sometimes to go directly to aninterventional catheter at the same time as thediagnostic catheter. If interventional catheterisation isneeded, then this will be discussed before theprocedure. On rare occasions, intervention may beconsidered when the diagnostic catheter is beingcarried out because of unexpected findings. In thissituation parental consent will always be obtainedbefore proceeding.Are there any alternatives?There is no other investigation that will provide thesame information.What are the risks?All medical procedures, however minor, have risks and
possible complications. Cardiac catheterisation ininfants and children is no different. In most patientsthe risks are very low, but it is never possible toguarantee a risk–free procedure.Are there any complications?Most complications are minor but seriouscomplications can delay your childs discharge fromhospital. The most common complication is for abruise to form in the groin where the catheter wasinserted. This is not serious, but may cause someinconvenience for a few days.The risk of death or serious complications is generallylow, though it is higher in:• Newborn or very small children• Children who are very blue (cyanosed)• Children with high lung artery pressures• Children where heart function is poor• Children with bleeding or clotting disorders• When Interventional and radio–frequency catheters are usedComplications can happen with all catheterprocedures. These complications include:• Bleeding from the blood vessel. This normally responds to pressure over the puncture site, but if the bleeding is serious your child may need a blood transfusion.
• Blood vessel blockage. A blood thinner (Heparin) or clot dissolver (Streptokinase) is usually all that is needed. Rarely, surgery is needed to unblock a vessel.• Arrhythmias (an abnormal heartbeat) commonly happen while moving the catheters through the heart. Catheter removal is usually all that is needed. Occasionally, medication, an electric shock, or a temporary pacemaker is needed to stabilise the heart rhythm.• Blood clots are usually prevented by giving blood thinning drugs (Heparin) during catheterisation. Clots rarely form and any brain effects are usually temporary. Permanent damage is extremely rare.• Catheter perforation of the heart and valve damage is rare. Usually no action is needed but needle aspiration of blood from around the heart is sometimes carried out. Rarely, a surgical repair is needed.• Anaesthetic complications include drowsiness, vomiting, high temperatures, and chest infections.Data ProtectionWe collect information about your child and familyrelevant to their diagnosis and treatment. We store itin written records and on computer. We may have toshare some of your information with other peopleand organisations. If you have any questions and/or
do not want us to share that information with others,please talk to the people looking after your child orcontact PALS (Patient Advice and Liaison Service)on 0121 333 8403.Central Cardiac Audit Database - CCADWhat is CCAD?CCAD is a national database used to hold patientinformation. The information is used to make surethat all cardiac surgery is carried out to the same highstandards throughout the United Kingdom.What information is held on the database?The database holds information about all heartoperations. Information held will include:• The patients name• The patients age• The patients post code• The patients condition• The operation carried out and its outcomeHow is the information used?The information is used by the Government tomonitor how well hospitals are performing. Each year,several sets of patient notes are checked byindependent auditors against the information on thedatabase to make sure that the information is correct.
Why is this information important?To make sure that all cardiac centres across thecountry are keeping to the same high standards,information about as many patients as possible isneeded.Can I opt out?If you do not want information about your childscondition and surgery to be included in the databaseto help us maintain our standards, speak to yoursurgeon or cardiac nurse. Your decision will not affector change the treatment your child will receive.
Please use this space to write down any notesor questions you might have