Cardiac Catheterization-Angiography Laboratory

After historical, physical, ECG and echocardiographic examinations there are two main reasons to perform cardiac catheterization- angiography on patients. Firstly, it is performed to obtain detailed information on the anatomies and functions of hearts of children with congenital or acquired cardiac diseases (diagnostic cardiac catheterization). Secondly, treatment of certain cardiac anomalies is aimed with interventional cardiac catheterization (therapeutic interventional cardiac catheterization).

What is diagnostic cardiac catheterization-angiography?

It is a test performed for obtaining detailed information on the structure of heart and on how it works. In this procedure, thin and small plastic tubes (catheters) are moved to heart through the blood vessels or arteries in inguinal or neck regions, the blood pressure in all heart cavities and in large vessels are measured and blood samples are collected. Furthermore, images of heart are obtained by injecting contrast agents (dye can be displayed on X-ray) to heart cavities and blood vessels with catheters. By means of this, the complex cardiac anomalies can be diagnosed and the type of surgery can be planned.

In most of the patients, general anesthesia is not required during diagnostic cardiac catheterization. The procedure can be performed by reducing the anxiety and pain with a sedative medication. It takes approximately 1-3 hours. After the procedure, the patients are monitored by being hospitalized for a day. The patients can continue their daily lives on the following day.

What is therapeutic interventional cardiac catheterization-angiography?

As in diagnostic cardiac catheterization, the procedure is performed by moving the catheters to heart with the help of a needle through the blood vessels in inguinal or neck regions. By means of this, the congenital or acquired cardiac disease can be treated without surgery. Closure of heart defects, recovery of valve or vessel stenosis are the most common procedures. The major heart defects that can be closured with interventional cardiac catheterization are patent ductus arteriosus (PDA), atrial septal defects (ASD), patent foramen ovale (PFO) and ventricular septal defects. In the department Amplatzer devices, Cook and pfm coils are frequently used in closure of these defects. Major stenoses that can be treated with interventional cardiac catheterization are pulmonary valve stenosis, aortic valve stenosis, peripheral pulmonary artery stenosis and aortic coarctation. Normally, balloon catheters are used during these procedures.

During interventional cardiac catheterization general anesthesia is administered to most of the patients for the safety of procedures and patients. Patients are discharged from hospital after being monitored for a day, following the procedure. They continue their daily lives immediately after they are discharged.

In where is cardiac catheterization-angiography performed?

It is performed in digital catheterization room which is recently renewed, in Pediatric Cardiology Unit. Recently purchased angiography device is two-armed and images from different sides can be displayed simultaneously. Thus, more images can be obtained with less amount of contrast agent. With this feature, the pediatric cardiac catheterization room is one of the few centers in Turkey.

By whom is the cardiac catheterization-angiography performed?

It is performed by Pediatric Cardiologists with the supports of assistant health personnel such as technician, nurse. When patient require general anesthesia an Anesthesiologist also participates in the procedure.

What are the considerations before the cardiac catheterization appointment?

• • Beginning from the night before, older children should fast for at least 8-12 hours and younger children should fast for 4-6 hours.

• • You should bring the medications that you use constantly with you.

• • You should ask your physician whether there are medications to be terminated prior to your appointment.

• • Patients with other chronic diseases (e.g. diabetes) should receive permission from related departments regarding cardiac catheterization.. Particularly, patients with diabetes should not take their diabetes medications (insulin or pill) on the morning of appointment day. Otherwise, your blood glucose may decrease to undesired levels, since you are hungry.

• • Please bring all documents related with your health coverage, private life insurance card or institution referral with you.

• • Please learn whether your official documents such as referral papers are expired or not.

• • You should bring your hospital file with you, if it is at home.

• • Please definitely bring the angiography film and report with you, if your patient had angiography before.

• • If your patient had a surgery in another center, please definitely bring the surgery report with you.

• • Please bring all blood test results, films and reports, if any, related with your disease.

How is daily appointment queue of cardiac catheterization-angiography test determined?
Patients are taken to cardiac catheterization test IN ACCORDANCE WITH THE APPOINTMENT QUEUE. However, the priority is of infants and younger children in cardiac catheterization test. Also, patients in case of emergency and inpatients who are in difficutl situation will HAVE PRIORITY FOR THE TEST

When will you receive the cardiac catheterization-angiography result?

The results of cardiac catheterization are evaluated soon after the test and submitted to family of the patient. However, final report is generally submitted after the COUNCIL meeting on the following Wednesday, after the catheter procedure. The defined further plans (when and how the patient will be operated if required, when the patient will come to control examination if she/he is needed to be observed clinically) are submitted along with the final report.