About the Cardiac Catheterization Laboratory
What is cardiac catheterization?
Cardiac catheterization is a procedure that can be used to diagnose and treat many heart conditions. During a cardiac catheterization, an interventional cardiologist threads long, flexible tubes, called catheters, up through your child's large blood vessels and into the heart. Many children undergo cardiac catheterization as part of their evaluation or treatment for various heart conditions. It is a highly specialized procedure that requires the expertise of a skilled and experienced team.
In the Cardiac Catheterization Laboratory at Children’s Hospital of Philadelphia (CHOP), our team of dedicated specialists performs more than 1,400 cardiac catheterization procedures each year on newborns, infants, children and adults. Our interventional cardiologists are recognized experts in the field of pediatric cardiac catheterization and have several decades of experience among them.
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Why your child may need cardiac catheterization
Cardiac catheterization is often used to diagnose certain heart conditions and better understand the structure and function of your child’s heart. In general, our cardiologists rely on noninvasive imaging tests like ultrasound and cardiac MRI; however, certain information about the heart can only be obtained by performing a cardiac catheterization.
Catheterization is also used to treat heart problems; this is called interventional catheterization. Advances in interventional cardiac catheterization have greatly changed the way we treat children with congenital heart disease. Some therapeutic procedures, such as atrial septal defect closures, can be performed during a catheterization, which means your child may not need to undergo open heart surgery. In many complex heart problems, the best treatment requires a combination of interventional catheterizations and surgical procedures.
Pediatric cardiologists usually rely on noninvasive imaging tests like ultrasound (echocardiography) and cardiac MRI to understand the structure of the heart and diagnose various heart conditions. In some cases, though, certain information is best obtained using cardiac catheterization.
We use diagnostic cardiac catheterization to accurately measure how well your child’s heart is pumping and how much blood is flowing and to where. We perform cardiac catheterization on newborns, infants, children and adults.
During cardiac catheterization, we thread long, flexible tubes, called catheters, up through your child's large blood vessels and into the heart. These catheters help us measure pressures and draw blood samples. We then use these measurements to determine how blood is flowing to different parts of your child's body. Sometimes we perform an angiogram by injecting X-ray dye through the catheters so that we can see important anatomic details of your child's heart.
We may perform a diagnostic cardiac catheterization on your child to:
- Diagnose a heart problem
- Learn more about a heart problem
- Obtain cardiac tissue samples (by biopsy) for lab testing and pathology examination
- Conduct an invasive electrophysiology study (EPS) if there is an abnormal heartbeat, which can help locate the origin of the arrhythmia and determine how best to treat it
Interventional (therapeutic) catheterization
Advances in interventional cardiac catheterization have greatly changed the way we treat children with congenital heart disease. Corrective or therapeutic procedures can be performed during a catheterization to either treat a congenital or acquired heart defect without surgery or complement a surgical procedure. The Cardiac Center at CHOP has the experience, technology and expertise needed to successfully use cardiac catheterization to treat a full range of congenital heart problems in children and adults.
Some of the most common pediatric interventional catheterization procedures performed at CHOP include:
- Closure of atrial septal defects (ASD), patent ductus arteriosus (PDA), ventricular septal defects (VSD), and a variety of other abnormal blood vessels
- Balloon valvuloplasty to treat:
- Treatment of blood vessel narrowings with balloon dilation and/or stent placement
- Pulmonary valve replacement procedures
- Interventions particular to the single ventricle population of patients
- Lymphatic interventions for the treatment of plastic bronchitis, chylothorax and other conditions involving lymphatic leaks
For some patients who have had surgical repair of certain forms of congenital heart disease such as Tetralogy of Fallot (TOF) and truncus arteriosus, the right ventricular outflow tract (the connection from the right ventricle to the pulmonary arteries) may become either too small or too leaky because it doesn’t have a functioning pulmonary valve in it, or both. For many of these patients, the right ventricular outflow tract can be opened up and a functioning valve replaced with a transcatheter pulmonary valve replacement. In this procedure performed in the Cardiac Catheterization Laboratory, a new pulmonary valve is placed by catheter techniques mounted inside of a stent. With the ongoing development of new types and sizes of transcatheter pulmonary valves, this option is now available to more patients with different sizes and shapes of outflow tracts, and is a less invasive alternative with a faster recovery than surgical pulmonary valve replacement.
Your child’s cardiologist will discuss the best treatment option based on your child's condition. The development of additional interventional cardiac catheterization procedures to treat other congenital heart conditions in children and adults is also continuing.
What to expect
The Catheterization Laboratory (also called the Cath Lab) team — made up of interventional cardiologists, cardiac anesthesiologists, nurses, radiology technicians, child life specialists and clinical care providers — focuses solely on patients who require catheterization. From the waiting room to the recovery room, every member of your child’s healthcare team is specially trained to care for children undergoing this procedure.
Certain cardiac catheterization procedures are performed in our state-of-the-art X-ray Magnetic Resonance (XMR) suite. Studies performed at CHOP have shown that performing catheterizations which utilize information from XMR imaging exposes pediatric patients to significantly lower doses of radiation. Our aim is to offer your child less invasive imaging and effective treatments so your child can recover quickly and return to a more normal life. Learn more.
The Cath Lab team at CHOP is also continually researching advances in cardiac catheterization procedures and is involved in many clinical trials. Our goal is to ensure these diagnostic services and treatment options, which are less invasive than open heart surgical procedures, are available to a growing number of our heart patients.
Our team's research has been published in a variety of medical journals. Read some recent articles to learn more about the work in which our team is involved.