Cardiac Catheterization

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At Children’s Minnesota, we partner with parents and caregivers to provide the best care for your child.  Please read the following information about the procedure and how you can help create a pleasant and successful experience for yourself and your child.

What is a Cardiac Catheterization?

A cardiac catheterization (heart cath) is a minimally invasive procedure that uses wires and catheters to gather information about the heart and lungs.  We can take samples, measure oxygen levels and blood pressures, look at the heart’s electrical system and take pictures using a special dye.  To get to the heart, the catheters are placed into the large vessels in the groin called femoral arteries and veins.  Depending on your child’s heart condition, sometimes the neck is used as well.  A special type of x-ray, called fluoroscopy is used to help put the catheters in the correct place.

Your child will be asleep under general anesthesia or sedated and comfortable during the procedure.  The procedure takes about 3 hours.  Recovery takes 3 to 4 hours.

How should we prepare at home?

A nurse will call you within 7 days before the procedure to review your child’s medical history, current medications, bathing and eating and drinking guidelines. If you have any questions, please ask them at this time. The nurse will tell you what time to arrive at the hospital.  Allow enough time for travel, parking and check-in.  Arriving late may delay or postpone your child’s procedure.  This phone call is brief but very important.  Please make sure to return our call if we leave a message.

Carefully follow the feeding guidelines given to you during this phone call.  Gum and hard candies are NOT allowed after solid foods are stopped.  Babies and children that take thickened feedings or receive pureed food formula (Nestle Compleat®), must stop thickened feedings earlier.  For the safety of your child, it is important to follow the specific feeding times.  If your child does eat or drink after the scheduled times, it will delay the procedure or cause it to be rescheduled to another day. Please check your child’s car seat for any loose snacks like crackers, cheerios and raisins and remove them as well.

Your child should have a full bath or shower the night before their procedure.  Have them wear clean pajamas and sleep in clean bedding.  On the day of the procedure, dress them in comfortable, easy-on clothing.

If your child becomes sick or you have any questions or concerns, please contact the Children’s Heart Clinic at 612-813-8800.

You will receive a call from Children’s Hospital Admitting Department prior to the appointment.  Please return their call so registration can be completed prior to arrival.

What do I tell my child?

Knowing what to expect and explaining it to your child beforehand is the best way for everyone to be prepared.  The following are some guidelines to use when preparing your child for the heart cath.

Your child may bring along a “comfort” item, such as a favorite stuffed animal or blanket.  Please wash the item the night before the procedure.  All of our rooms have TVs with cable channels and pre-loaded movies available for your child.  Age-appropriate books about going to the hospital might be helpful.

Birth to 2 Years

Please bring a “comfort” item and a clean and empty bottle or sippy cup of theirs from home to use after the procedure.

Toddlers

One to two days before your child’s heart cath, explain the procedure using simple words. 

• Parental presence is helpful.
• Tell them where you’re going, who they will meet and how it will help them. You might explain, “The doctor will take pictures of your heart while you take a nap.”
• Encourage choices when appropriate. Allow your child to choose what stuffed animal to bring to the hospital.
• A medical play kit might be helpful so that your child is familiar with the items he or she may see. For example, you can show your child how to use a stethoscope on a teddy bear.

Preschoolers

Preschoolers have amazing imaginations and for what they don’t understand, they often create their own explanation.

• Invite them to bring a favorite blanket, toy or other comfort item.
• Explain what will happen during the visit and how it will help your child.
  • Play hospital or doctor-play is how preschoolers learn.
  • Draw pictures to explain what will happen (stick figures work just fine).
  • Look at a children’s book about going to the doctor or hospital.
• Talk to your child honestly about the hospital with words they can understand.
• Provide choices when appropriate that allow them to be actively involved in their care.

Elementary School Age

Older children may benefit from discussing the heart cath about 1 week before the scheduled date.  At this age, kids understand more about the body and how it works.

• Invite them to bring a favorite blanket or other item.
• Allow your child the chance to ask questions and talk about concerns.
• Find out what they already know and explain what they don’t know.
• Be honest. Explain what will happen, who they will meet and how it will help them.  Also mention what they will see after the procedure (bandages and IV).
• Provide choices as appropriate that allow them to be actively involved in their care.

You can explain to your child that they will be getting medication to make them very sleepy throughout the heart cath and the medication will keep them comfortable during the procedure.  The medicine will also make it difficult to remember much about the heart cath afterwards.  You may want to add that the heart works like a pump and that the heart cath will help the doctor see how well your child’s heart is pumping. 

Teenagers

Preteens and teens are able to understand how the heart works, what is special about how their heart works and why they need this procedure.  They may be concerned with body image, privacy and control over their experience.

• Invite your teen to bring something to provide comfort and distraction.
• Talk honestly about what’s going to happen. They may ask very insightful questions; use their questions to guide your discussion.
• Encourage your teen to participate in decision-making and to ask questions of their healthcare providers.
• Support their inclusion and involvement with their care.

What Happens the Day of the Procedure?

Check in at the 2^nd Floor Welcome Desk at the specified time on the date of your child’s procedure.  Inform the desk attendant your child is here for a heart procedure.  They will complete your check-in and call us to escort you and your child to the PAR4 area.  PAR4 is the area where your child will get ready for and recover from their procedure.

Your child will take off all clothes, use antibacterial wipes on his or her body and put on hospital pajamas and be screened for pregnancy if your child has a uterus, is 10 years old or older, is younger than 10 but has started their periods, OR state they are sexually active.

The nurse will check your child’s vital signs, height and weight and the anesthesia team will meet with you and explain the plan for keeping your child asleep and comfortable during their procedure. The cardiologist will meet with you to review the procedure and answer any questions you might have. 

You will be asked to sign a consent form allowing the anesthesia and procedure.  Toddlers and children may receive a medication to help them relax before the procedure. Teens will have an IV (intravenous line) placed in PAR4, while babies and children will usually have their IV placed once asleep.  The anesthesia team will escort your child to the cath lab.  Your child’s blood pressure, oxygen levels and heart and breathing rates will be monitored the entire time. 

The nurse working in the cath lab will meet you and your child prior to the procedure.  The nurse will update you regularly during the procedure.

What can I expect after the procedure?

When the procedure is complete, the cardiologist will meet with you and review the information from the heart cath.  The cardiologist will decide if your child goes home or must stay in the hospital overnight.  Your child will be brought back to the room they got ready in.  Parents or caregivers will be called when they begin to wake up.  You can help your child by talking softly and staying calm.  Your child will need to lay still and quiet for 3 to 4 hours after the procedure to minimize bleeding at the catheter site.  Sometimes a medication will be used to help keep your child drowsy during this time. 

Your child should not bend their knees, sit up, or lift their head up off the bed.  The pressure caused by these activities can cause bleeding at the groin site. The nurse will tell you when your child can get up.

The nurses will frequently check your child's vital signs (heart rate, breathing, temperature, blood pressure) and pulses in the feet and legs.

When your child is fully awake, they will be moved to an inpatient room for the overnight stay or discharged to home after the quiet time is over.  Your child will be allowed some water, juice and crackers once awake. 

How can I care for my child?

Watch the catheter site(s) for bleeding. If bleeding occurs, apply pressure directly on the site for 5 continuous minutes with a clean washcloth or gauze and call the Children’s Heart Clinic at 612-813-8800 right away.

Expect a small amount of bruising around the insertion site. Watch for increased bruising or swelling.

Wound care: Your child will have a bandage or pressure dressing where the catheter was inserted.  The smaller dressing underneath can be removed the following morning and replaced with a bandaid. Place new adhesive bandage on site each morning for the next 3 days.  If the bandage is dirty, put on a new bandage.  Keep the site clean and dry. 

Bathing: Do not allow bath tubs, swimming, hot tubs until the sites are completely healed, about 1 week, to prevent infection.  Showers and sponge baths are permitted. When bathing, you may clean the site gently with soap and water. 

Watch your child for any signs of infection including:

• redness
• swelling
• drainage at the catheter sites
• warmth at the catheter sites or
• fever higher than 101° F (38.4° C)

Compare the temperature and color of your child's legs several times a day for two days. Check to see if the leg used for the catheterization is cooler, paler, or darker than normal.

Diet: Start slowly with resuming a regular diet beginning with easily tolerated foods and drink.  Your child can eat a regular diet similar to what they would eat after an upset stomach.  Do not eat heavy or greasy food.  Help your child by encouraging water or juice.

Acitivity: Your child may be sleepy for the remainder of the day and should take it easy and have quiet play.  Once your child has been discharged, they can return to school or daycare in 1-2 days after the procedure.  For the first 3 days (or directed by your provider) after the procedure, avoid contact sports, rough play, or any activity that could cause a fall. Do not allow:

• riding bikes and other riding toys
• physical education classes
• swinging
• jumping
• heavy lifting
• swimming

Medicine: You may give your child acetaminophen (Tylenol®) as needed for any discomfort from the catheter sites. 

If your child is taking aspirin, do not give ibuprofen. Before giving acetaminophen, be sure to check your child's temperature.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call the Children’s Heart Clinic at 612-813-8800.

Last reviewed 1/2021

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