cardiac catheterisation - royal brompton hospital · surgery. • interventional cardiac catheter...

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Cardiac catheterisation

Information for patients and carers

Cardiac catheterisation_Patient Booklet 23/07/2015 15:32 Page 2

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What is cardiac catheterisation? 3

Are there any possible complications of cardiac catheterisation? 5

What happens before cardiac catheterisation? 5

What will happen when we arrive at the hospital? 6

What happens after cardiac catheterisation? 7

Going home after after cardiac catheterisation? 7

Your follow-up appointment 8

Getting to the hospital 9

Useful contact details 11

Contents

This leaflet gives you general information about cardiaccatheterisation for your child. It does not replace the need forpersonal advice from a healthcare professional. Please ask us ifyou have any questions.


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What is cardiac catheterisation?

Cardiac catheterisation is away to find out detailedinformation about your child’sheart. It is used to diagnoseand treat certain heartconditions.

Children are given a generalanaesthetic so they are asleepwhile the procedure is carriedout. We then insert a thintube called a catheter into ablood vessel, usually in thegroin. The catheter is pushedgently up the blood vesseltowards the heart. Afluoroscopy (a low dose X-ray)– shown on a TV monitor – isused so we can view thecatheter’s progress.

Once the catheter is in place,we measure the bloodpressure in different parts ofthe heart. A special dye issometimes injected throughthe catheter to make thearteries show up more clearlyon the X-ray.

Another test, called atransoesophagealechocardiogram (TOE), can bedone at the same time as thecardiac catheterisation. TOE isa special type of ultrasound

scan that uses sound waves tocreate clear moving pictures ofthe heart. It involves a smalltube being threaded downthrough your child’s mouth.TOE enables us to see clearpictures of your child’s heartfrom a different angle, whichcan be very helpful.

This additional procedure isonly carried out with yourconsent.

Once the cardiaccatheterisation is completed,we put a dressing over theentry site (at the top of thechild’s leg) to stop anybleeding.

The results of the cardiaccatheter are usually availableimmediately, but for somechildren additional tests maybe needed. Sometimes adecision on further treatmentis only made after discussionat our weekly joint cardiacconference, which all of ourcardiologists, surgeons andintensive care doctors attend.If this happens, yourcardiologist will contact you totalk about the treatmentoptions.


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There are three different typesof cardiac catheterisation

• Diagnostic cardiac catheter

This helps us decide the bestway to treat more complexconditions, including theplanning and timing ofsurgery.

• Interventional cardiaccatheterSometimes we can treatcardiac conditions with aninterventional catheter,instead of heart surgery. Forexample, we can use it to:

• make extra holes in theheart to treattransposition (round thewrong way) of the greatarteries

• close holes to treat someatrial septal defects andventricular septal defects

• close ducts to treatpatent ductus arteriosus

• insert stents (small metaltubes) to keep bloodvessels open in cases ofaortic narrowing

• stretch narrowing valvesor blood vessels using aballoon on the end of the

catheter in patients withpulmonary stenosis andaortic stenosis.

• Electrophysiology study andradiofrequency ablation

An electrophysiology studyis a test to measure theheart’s electrical activity anddiagnose abnormal heartrhythms. We use a catheterwith an electrode at the tip(a small piece of metal thatconducts electricity) tocollect information aboutthe heart's electrical activity.

It is often possible to usethe electrode to deliverelectrical pulses to ablate(destroy) the small areas ofthe heart that are causingthe problem.


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Cardiac catheterisation is verysafe, but there are risks to anyprocedure. These will be fullyexplained to you when we aregetting your permission to goahead with the procedure.

Complications can include:

Rhythm disturbances Sometimes the heart can beatabnormally while the cathetermoves inside the heart. Usuallyit returns to normal once theprocedure is over, butoccasionally treatment – a mildelectric current or a temporarypacemaker – may be neededto stabilise the rhythm.

Blood vessel blockage Blood vessels in babies andchildren are small, and cardiaccatheters can cause blood clots

to form and block the bloodflow. This is usually temporaryand corrected with a medicinecalled heparin.

Bleeding from the bloodvessel Bleeding from the vessel canbe stopped by using a dressingto apply pressure to the entrysite (usually the groin, wherethe catheter was inserted).

Side effects of the anaestheticYour child may be drowsy, feelsick, and need time to feelbetter after a cardiaccatheterisation. If this happenswhen the procedure has beencarried out in the afternoon,we will ask you to stay anextra night in hospital forobservation.

Are there any possible complications of cardiaccatheterisation?

The paediatric co-ordinatorswill call you to arrange yourchild’s admission to thehospital. They will then sendyou a letter confirming detailsof the admission. At this stageit is very important you tell usif your child is unwell with

cold or flu-like symptoms, ordiarrhoea or vomiting. Thecardiac catheterisation mayneed to be delayed.

It is also very important yourchild does not have anyoutstanding dental treatment.

Before the cardiac catheterisation


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What will happen when we arrive at thehospital?

When you arrive on RoseWard, you will be shown toyour child’s bed.

We will observe your child andtake swabs to test for MRSA(methicillin resistantstaphylococcus aureus) – acommon infection.

Your child may also have anECG, a test to record heartrhythm, and anechocardiogram, also known

as an echo, a test that usessound waves to build up amoving picture of the heart. Ifyou would like moreinformation about either ofthese tests, please just ask.

You will meet with acardiologist to discuss thecardiac catheterisation and tosign the consent form.

You will be able to go withyour child to the catheter

Problems with teeth or gumscan be a major source ofinfection and bacteria (germs)can enter the bloodstream andget into the heart. This iscalled endocarditis and canseriously damage the heartvalves and cause other majorcomplications. If your child hastooth decay or needs anyfillings, the cardiaccatheterisation will need to berescheduled.

You will also be asked to callthe paediatric bed co-ordinatorthe day before admission tomake sure there is a bedavailable for your child.

It is important your child hasan empty stomach beforebeing given the anaesthetic.This means your child willneed to be ‘nil by mouth’(given no foods or fluids)before the cathetercatheterisation.

If your child is coming in onthe day of the cathetercatheterisation, they will needto be nil by mouth from 2amon the morning of admission.If your child is admitted theday before, the nurses will tellyou when to stop giving yourchild food or drink.


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laboratory and stay until theyare asleep (under anaesthetic).A nurse will then escort youback to the ward.

A cardiac catheterisation cantake anything from 30 minutesto several hours, depending onthe complexity of the studyand what we need to do.

What happens after cardiac catheterisation?

Your child will return to RoseWard after they haverecovered from theanaesthetic. The nurses willcheck on your child regularly.They will make sure thecatheter site is not bleedingand that your child’s leg has agood blood supply. We do this

by checking its colour and howwarm it is. Your child will stayon the ward for a few hours(and possibly overnight). Wewill make sure they are nolonger drowsy, have hadsomething to eat and drink,and have passed urine beforethey go home.

Going home after a cardiac catheterisation

Wound care The entry site is quite smalland does not need stitches. Itwill heal in a few days. Thearea around the site maybecome a little bruised. Yourchild can have a bath orshower every day, but shouldavoid long, hot baths for thefirst three days after theprocedure.

Medication After some catheterinterventions, aspirin isprescribed for three months.

Returning to normal activities Your child may be tired tobegin with, but should be ableto return to school and allnormal activities within acouple of days.

When to call for advice It is very important to call theclinical nurse specialists inchildren’s cardiac careimmediately if any of thefollowing occur:

• there is bleeding from theentry site


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Your follow-up appointment

We will check on your child’sprogress at a follow-upappointment. This usuallytakes place three months afterthe cardiac catheterisation. Wewill write to you with details

of the appointment. Pleasecontact your clinical nursespecialist if you have notreceived details of theappointment within six weeksof discharge.

• the entry site becomes red,swollen, painful or hot totouch

• the leg becomes discolouredor feels colder than theother leg

• your child complains of“pins and needles” in theleg.

If you are concerned aboutyour child’s colour,breathing or if there isexcessive bleeding fromthe catheter site, pleasecall 999 for an ambulance.Your child will be taken tothe local accident andemergency unit forassessment.


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Getting to the hospital

You need to make your ownway to and from the hospital.Please be aware that there islittle or no car parking available.

By busBuses 14, 211 and 414 all stopoutside the Fulham Wingentrance to the hospital.

Buses 49 and 211 stop outsidethe Sydney Street entrance.

Buses 11, 19, 22 and 319 alltravel along the King’s Roadand stop near the corner ofSydney Street, which is abouta five-minute walk from thehospital.

By tubeThe nearest tube station isSouth Kensington on theCircle, District and Piccadillylines. It is a 10-minute walkfrom the hospital. The 49 bustravels from South Kensingtonstation to the hospital. Taxisare also available.

By rail The nearest mainline trainstations are Victoria stationand West Brompton station.

Both have good tube and busconnections to the hospital.

Admission is usually for onenight, but please comeprepared for a two-night stay.One parent or carer can sleepat the child’s bedside. Pleasepack lightly as space is limited.

By car If a family member is drivingyou in by car, they can dropoff or pick up at the mainhospital entrance in SydneyStreet.

Parking for patients andvisitors Royal Brompton Hospital is ina pay-and-display parkingmeter zone (street parking).

There is a public car park threeminutes' walk away on SydneyStreet, near King's Road.

Parking for disabled badgeholdersA small number of disabledparking spaces are available in:

• Cale Street

• Foulis Terrace

• Sydney Street (near themain hospital entrance).

Remember to display yourdisabled badge.


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Map showing Royal Brompton Hospital


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Clinical nurse specialists in children’s cardiac care 020 7349 7727 (direct line – available Monday to Friday from 8am-6pm)

Harefield Hospital paediatric department 01895 823 737 extension 75573

Rose Ward 020 7352 8121 extension 2412 or 2413 (24-hour)

Family liaison team 020 7352 8121 (available Monday to Friday from 8am-6pm) extension 8588

The family liaison team works with families both on paediatricintensive care unit and Rose Ward. Its role is to provide supportfor the parents / carers of children who are patients. If you feelyou would like to talk to one of the team members aboutanything, they are always happy to listen.

Paediatric co-ordinators 020 7352 8121 extension 2118 then for bleep 1256

Paediatric bed co-ordinator 020 7352 8121 extension 8588 then for bleep 7078

The Brompton Fountain 03300 22 92 91 (direct line) www.thebromptonfountain.org.uk

The Brompton Fountain is a charity that supports children withlife threatening medical conditions who are under the care ofRoyal Brompton and Harefield NHS Foundation Trust.

Useful contact details

If you have concerns about any aspect of the service you havereceived in hospital and feel unable to talk to those peopleresponsible for your care, call PALS on 020 7349 7715 or [email protected]. This is a confidential service.


Royal Brompton HospitalSydney StreetLondonSW3 6NPtel: 020 7352 8121textphone: (18001) 020 7352 8121

Harefield HospitalHill End RoadHarefieldMiddlesexUB9 6JHtel: 01895 823 737textphone: (18001) 01895 823 737

Website: www.rbht.nhs.uk

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© Royal Brompton & Harefield NHS Foundation Trust July 2015


cardiac catheterisation - royal brompton hospital · surgery. • interventional cardiac catheter...

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