A number of invasive procedures occur in the Cath lab for the treatment/diagnosis of various heart condition including Congenital Heart Defect (Hole in the Heart). The most common ones are; Angiography, others include oxygen study, pacemaker insertion, balloon valvuloplasty, coronary study, defect closure, stenting etc.
CARDIAC CATHETERIZATION
This is indicated for a number of children and adult with CHD. A Registered Nurse admits you into the hospital, takes history, and medications you or your child is on. Some might need to be discontinued e.g warfarin, metformin, etc.
An anaesthetist will meet you to ask a couple of question relating to the history of allergy, drugs reaction etc.
The interventional Cardiologist (Adult or Paed) explains the procedure and makes you consent.
Consent is a document permitting healthcare practitioners to go ahead with a treatment (especially invasive ones) A Consent can be signed by the patient themselves, their spouses or next of kin, and for minors (less than 16-18 years of age) a parent or guardian is responsible for consenting.
Cathlab Nurse and team may also meet you to ascertain readiness for the procedure.
Preparation
For an adult patient, the skin around your groin may be shaved clean for easy accessibility and prevention of infection as the catheter is introduced into the area. Patient is also asked to fast 6 hours before the procedure and patient may be on NPO and intravenous fluid commenced through an IV access. Certain drugs may be taken with little sips of water which your Nurse will tell you.
Alert.
Antihypertensive should be taken please while anticoagulants and antiplatelet stopped at least 2 days before.
Let your nurse know if you suspect that you are pregnant
Description of procedure
Cardiac catheterization involves passing a catheter (a thin tube) through a large blood vessel around the groin or hand, guided by a fluoroscope (an X-ray machine) into the heart. Then based on the clients condition and need, any of the following can be done:
Contrast (dye) may then be injected to visualize the blood vessels of the body as it goes into the heart. An example is in coronary angiogram;
Blood sample may be collected for studies to check oxygen saturation in various chambers of the heart and calculate other parameters. Blood Pressures in various part of the heart or lungs can also be read and calculated as well;
Balloon can also be used to widen the size of narrowed blood vessel or valve, a procedure called Baloon Valvuloplasty;
Occluders can be used to close very small holes in PDA or ASD;
Stent can also be used to open up plaque in a blood vessel.
Access catheter may be removed thereafter or later in the ICU once clotting test is normal.
Post Cardiac Cath.
After the procedure, patient is taken to the PACU or ICU or ward as the case may be for recovery. Depending on the procedure done, patient may be discharged 6-24 hours after.
The site is covered with a sterile dressing, however, access site is observed for any sign of bleeding or haematoma
Blood supply to the lower part of the body is checked by checking pulses around the limb. Watch out for a cold than normal body part compared to the other. If your Nurse suspects this, your physician may request a Doppler test.
Feeding may resume 2 hours thereafter
Pain medication is given and antipyrexia.
After discharge, if you have any concern, do not hesitate to call your Cardiologist or get back to the hospital.