Catheterization

My son has a heart problem from birth. I was told that it requires cardiac catheterization. What is cardiac catheterization? What is it for? Is it needed in all cases?

Currently, congenital heart defects are mostly diagnosed in pediatric age, some in the prenatal stage and to a lesser extent in adulthood. Advances in diagnosis, knowledge of cardiovascular anesthesia, intensive care, and cardiac surgery have facilitated the survival of children with complex congenital heart defects. Thus, the majority of congenital heart defects can be effectively diagnosed with non-invasive methods. However, in some cases, it is not possible to adequately define the characteristics of heart disease and it may be necessary to perform a procedure called cardiac catheterization for diagnostic purposes (to determine heart pressures, oxygen saturation of the heart chambers, evaluation of vascular resistance and drug response; measurement of heart and vessel structures to calculate indices for univentricular bypass surgeries, define pulmonary irrigation, among others) and to solve problems (interventional catheterization).

Likewise, in post-surgical care, catheterization is used when the patient presents clinical suspicion, diagnostic doubt by non-invasive methods, or presents a post-surgical torpid evolution. For the performance of catheterization, the support of anesthesiology is necessary. This procedure is performed through puncture of veins or arteries.

We understand as Interventional cardiology the application for therapeutic purposes of cardiac catheterization techniques. Therapeutic catheterization has replaced conventional surgery in the treatment of some congenital heart defects, it is an alternative in other injuries and, on the other hand, new techniques and devices are undergoing clinical experimentation with promising preliminary results. The future improvement in techniques and materials augurs a brilliant future for this type of therapy. However, we must remain cautious about the still limited information on the long-term results of some of these techniques.

Performing procedures in interventional cardiology (general list)

A.- Valvuloplasties
Pulmonary valve stenosis
Aortic valve stenosis
Mitral stenosis
Pulmonary atresia with intact septum

B.- Angioplasty
Aortic coarctation
Pulmonary branch stenosis
Pulmonary vein stenosis
Small ductus arteriosus in ductodependent heart disease

C.- Atrial septostomy
1.- With the ball. Atrioseptostomy (CIA extension).

2.- With blade.

D – Defect closure

1.- Patent ductus arteriosus (PCA). Close with device.

2.- Interatrial communication type ostium secundum (CIA). Device.
3.- Interventricular communication (CIV). CIV closing device.

4.- Patent foramen ovale (FOP). FOP closing device.

E.- Post-surgical stenosis dilation

1.- Aortic excision

2.- Biological prosthesis stenosis

3.- Stenosis of ducts formed by patch

4.- Senning or Mustard operation

5.- Systemic pulmonary fistula stenosis

6.- Residual valve stenosis

7.- Other post surgical stenosis

F.- Endovascular prosthesis implant

1.- Vascular occluders (embolization)

2.- Stent

3.- In surgical procedures (hybrids)

G – Extraction of foreign bodies

H – Drainage of pericardial effusion

I – Ablation of abnormal conduction pathways

J – Pacemaker Electrode Implant