Heart Catheterization In Children

WHAT YOU SHOULD KNOW:

A heart catheterization is a procedure to look at your child's heart and blood vessels. Caregivers can also use the catheter to check the pressure in your child's heart and lungs.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

A heart catheterization could cause bleeding, a bruise, and soreness where the catheter went in. Your child could bleed so much that he may need a blood transfusion or surgery to repair the hole. He could get a blood clot in his arm or leg. Blood clots may break free and go to your child's lungs or brain and cause a stroke. Your child could have an irregular heartbeat or heart attack. He could get a collapsed lung or an infection. Your child could have kidney problems from the dye used during the test.

WHILE YOU ARE HERE:

Before your child's procedure:

• Informed Consent:
  
  
  • You have the right to understand your child's health problem. You should understand what tests, treatments, or procedures may be done to treat your child's problem. Your child's caregiver should also tell you about the risks and benefits of each treatment.
    
    
  • You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives a caregiver permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your child's caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered. This way you will understand what may happen to your child.
  
  
• Blood tests: Your child may need blood taken to see how his body is doing. He may need to have blood drawn more than once.
  
  
• Chest x-ray: Caregivers use the x-ray pictures to see how his body is handling the heart problem.
  
  
• Heart monitor: This machine monitors how your child's heart is doing before, during, and after the procedure. Up to 5 sticky pads are placed on your child's chest. Each pad has a wire that is hooked to a monitor or to a small portable box.
  
  
• IV: Your child's IV may be hooked to a machine that will give him liquids and medicine. The IV may be put in your child's hand, arm, ankle, or foot. Caregivers may numb your child's skin before they insert the catheter.
  
  
• Pulse oximeter: This machine measures the amount of oxygen in your child's blood.
  
  
• Vital signs: Caregivers will check your child's temperature, pulse, respirations (breaths), and blood pressure. Your child's caregiver may put an X over the spots on your child's feet and wrists where the pulse is strongest.
  
  
• Safety: Your child's caregivers will help your child get comfortable on the bed. A belt may be put over your child's legs for safety. Your child's arms may be tucked at his sides to give caregivers more room to work.
  
  
• Medicines: Your child may be given a sedative right before the procedure. He may take the sedative by mouth or through an IV. This medicine may make your child feel relaxed and drowsy. It may make your child go to sleep.
  
  
• Anesthesia: This medicine makes your child comfortable during surgery. Caregivers may work with you to decide which anesthesia is best for your child. Your child may sleep for a few hours after the procedure because of the anesthesia. Caregivers may put numbing medicine where the catheter will go in. Your child may also be given medicine through his IV. This medicine will keep your child comfortable and asleep during the procedure.

During the procedure:

• A catheter will be put into a blood vessel in your child's groin or arm. The catheter is gently threaded through the chambers in the heart.
  
  
• If the procedure is a right heart cath, the catheter will go into the pulmonary artery. The pulmonary artery is the blood vessel that takes blood from the heart to the lungs to get oxygen.
  
  
• If the procedure is a left hearth cath, the catheter will go into the aorta. The aorta is a large artery (blood vessel) that takes oxygen-filled blood to the rest of the body. Sometimes caregivers will use 2 catheters to look at both sides of the heart.
  
  
• Caregivers will use an x-ray machine to help them thread the catheter to the right place. Caregivers will put dye through the catheter.
  
  
• When the procedure is finished, the catheter will be removed. Caregivers will put pressure on the area where the catheter came out. This is to stop the bleeding. A pressure bag may be put in place for 2 or more hours. Your child may have stitches to stop the bleeding. It is important for your child to lie flat and to keep the leg or arm that had the catheter very still. This is to prevent bleeding.

After your child's procedure:

• Caregivers will watch your child closely for any problems. They will take your child's vital signs every 15 minutes for 1 to 2 hours. The pulses in your child's feet or wrists will also be checked often. Your child's toes or fingers will be checked to see if they are warm. Caregivers will watch your child closely for problems that can happen after a heart catheterization. Tell your child's caregiver if your child has any of the following:
  
  
  • Chest pain or discomfort
    
    
  • Change in color or temperature of his arm or leg
    
    
  • Swelling or bleeding from the area where the catheter was placed
    
    
  • Pain, numbness, or tingling in his arm or leg
    
    
  • Pain in his back, thigh, or groin
    
    
  • Nausea
    
    
  • Sweating
  
  
• Activity:
  
  
  • Your child will need to lie flat and still in bed for about 4 hours to prevent bleeding. You may be asked to hold your child to help keep him still. Your child's caregiver will tell you when it is OK for your child to get out of bed.
    
    
  • Do not raise the head or foot of your child's bed without asking a caregiver. Do not remove your child's pressure bag or bandage.
    
    
  • Tell your child's caregiver if your child is uncomfortable or tired of lying on his back. Caregivers may have ways to make your child more comfortable.
    
    
  • Help your child or call a caregiver to help the first time your child gets out of bed. Your child may feel weak, dizzy, or sleepy. Help your child when he gets out of bed to prevent him from falling or hurting himself. Your child must use a bedpan or urinal during the time that he must lie flat. After your child's caregiver says it is OK to get out of bed, you may help your child walk to the bathroom.
  
  
• Food: Your child may be on a clear liquid diet. He may have water, apple juice, soup broth, or clear soft drinks. If his stomach is not upset, he may be able to eat finger foods. Help your child to drink as much water as he can. This will help to flush out the dye from your child's body.
  
  
• Nausea medicine: This medicine may be given to calm your child's stomach and control vomiting.