Cardiology | Catheterization

Diagnostic and Interventional Catheterization

The cardiac catheterization service at St. Louis Children's Hospital is responsible for invasive diagnosis and therapeutic interventions for children with congenital and acquired heart disease. Diagnostic catheterization is performed to assist in diagnosing complex heart conditions, and to help decide on further treatments. Interventional techniques have also been developed that allow for open heart surgery to be avoided, or to help improve recovery after surgery.

• Follow a patient on a virtual tour of the catheterization lab.
• Read about procedures performed in the catheterization lab.
• Learn what to expect if your child needs to have a cardiac catheterization.

Catheterization Laboratory Procedures

(This is a list of example procedures. It is not intended to be an exhaustive list of all procedures available.)

Diagnostic catheterization

This is the basic procedure that includes placement of the catheters, measurement of pressures and oxygen content in the blood in each of the heart chambers, and injecting dye for the angiograms. An angiogram provides the permanent visual record of the structure and function of the heart. A catheter is a long thin tube that extends from the entry point, usually in the groin, and enters into the heart chambers and the vessels that extend from the heart.

Pulmonary and aortic valve dilation

A specialized catheter with a balloon for dilation is placed across the narrowed aortic or pulmonary valve. Fluid is then used to inflate the balloon to open the abnormal valve.

Aortic coarctation and pulmonary artery dilation

A balloon dilation catheter is placed across the narrowed segment of the aorta or pulmonary artery. The balloon is then inflated with fluid to open up the narrowed area.

Ventricular septal defect (VSD) occlusion (Amplatzer Septal Occluder)

A VSD is a hole between the bottom chambers of the heart. The VSD can be closed with an occlusion device delivered through a catheter, plugging the hole. This prevents the need for open heart surgery.

Intra-vascular stent placement

The stent (a tube made from a meshwork of wires) is mounted over a balloon dilation catheter. The balloon is then placed opposite the area of the narrowed artery. When the balloon is dilated, the stent also dilates, and remains expanded once the balloon is deflated.

Patent ductus arteriosus (PDA) occlusion (Amplatzer Occluder device or coil occlusion)

The PDA is a vessel which usually closes spontaneously in the first 24 hours after birth. If this vessel does remain open, it can be closed either with a small cone shaped device or a small flexible coil, delivered through a catheter. Both of these devices induce clotting and closure of the PDA.

Atrial septal defect (ASD) occlusion (Amplatzer Septal Occluder)

An ASD is a hole between the upper chambers of the heart. The ASD can be closed with an occlusion device, delivered through a catheter, resulting in plugging of the hole. This prevents the need for open heart surgery.

Foreign body retrieval

Various devices such as loops, snares and bioptomes can be used to retrieve broken IV lines or other material that becomes lodged within vessels or the heart.