Cardiac Catheterization Laboratory 

Making pediatric cardiovascular patients' hearts healthier now takes less time, with less exposure to radiographic dyes and X-rays and shorter time under heavy sedation or general anesthesia. This will result in reduced risk for complications.

Making these advantages possible to pediatric heart patients throughout our region was the opening of Wolfson Children's Hospital's new cardiac catheterization laboratory in the Children's Heart Center.  The lab is the first pediatric lab to feature this new technology by GE Healthcare, and the fourth in the world. Wolfson is a beta site that will draw pediatric cardiologists from throughout the country to observe the equipment in use.

The new lab uses flat-panel, biplane acquisition, completely digital technology called Innova 2121 that was custom-designed for Wolfson. The Innova 2121 significantly enhances the quality of images and is customized to include the features that are valuable to pediatric cardiologists.

One feature of the new equipment is two imaging arms with angulations that can be achieved independently. They are combined to get the most information out of each contrast injection for each child so physicians can minimize their exposure to radiographic dye and X-rays. It's not necessary to take multiple pictures of the same structure because specialists can get the correct angles in one shot.

Diagnostic Catheterization

Diagnostic cardiac catheterization, which is used to determine the function of the heart (i.e. blood flow) and to identify abnormalities, is the process of introducing, under local anesthesia, catheters ( into veins and/or arteries in the neck, leg or arm, from which they are advanced to the right and/or left sides of the heart. Once the catheters are positioned in the various heart chambers or blood vessels, the pressure of the blood in various chambers of the heart can be measured, blood samples can be taken, and dye can be injected to allow x-ray visualization.

Most often in children, diagnostic catheterization is used to diagnose congenital heart disease, a term that refers to one or more of several conditions which are present at birth (birth defects). Some congenital heart conditions include:

  • Atrial septal defect (ASD) - In this condition, there is a hole between the two upper chambers of the heart. Although blood from the left atrium flows into the right atrium through this defect, there may be few, if any, symptoms of this condition in infants and children, except for a possible heart murmur (an abnormal sound heard through the stethoscope when listening to the heart).
  • Ventricular septal defect (VSD) - In this condition, a hole occurs between the two lower chambers of the heart. Because of this hole, blood from the left ventricle flows back into the right ventricle, due to higher pressure in the left ventricle. This causes an extra volume of blood to be pumped into the lungs by the right ventricle, which can create congestion in the lungs.
  • Patent ductus arteriosus (PDA) - In the fetus, a connection occurs naturally between the pulmonary artery and the aorta. However, shortly after birth, this connection closes on its own. Sometimes, the hole does not close, which means that oxygenated blood from the aorta returns back to the lungs through the pulmonary artery, causing congestion in the lungs, increased workload on the heart, and may lead to an enlarged heart.
  • Obstruction defect - This general term refers to several different congenital conditions that cause an obstruction in the flow of blood through the heart. Obstruction defects include:
  • Aortic stenosis - A stiffening of the aortic valve (the valve between the left ventricle and the aorta).
  • Pulmonary stenosis - A stiffening of the pulmonary (or pulmonic) valve (the valve between the right ventricle and the pulmonary artery).
  • Bicuspid aortic valve - A defect in the aortic valve, in which there are only two cusps (flaps) in the valve instead of the normal three.
  • Subaortic stenosis - A narrowing of the left ventricle just below the aortic valve, usually from the septum.
  • Coarctation of the aorta - A narrowing or constriction of the aorta, which obstructs blood flow from the heart to the rest of the body tissues.
  • Tetralogy of Fallot - In this condition, there are actually four separate defects occurring at the same time: ventricular septal defect, pulmonary stenosis, overriding aorta (the outflow tract of the aorta begins just above the ventricular septal defect instead of at the normal location in the left ventricle), and right ventricular hypertrophy (enlargement of the muscle of the right ventricle)
  • Transposition of the great vessels - The outflow tracts of the aorta and the pulmonary artery are switched during fetal development. This means that unoxygenated blood flows out to the body through the pulmonary artery and oxygenated blood flows back into the lungs through the aorta. 
  • Tricuspid atresia - The tricuspid valve between the right atrium and right ventricle is missing. By itself, this would mean that no blood can be pumped into the lungs to receive oxygen; however, there are usually accompanying defects that allow some blood to go to the lungs.

Interventional Catheterization

These procedures are used to correct a child's heart condition. Some of the procedures performed for treating patients in the cath lab include:

  • Balloon angioplasty- Pediatric cardiologists use a balloon to open a narrowed heart vessel.
  • Balloon valvuloplasty- Similar to angioplasty, but the balloon-topped catheter opens a narrowed heart valve. 
  • Arrythmia ablation - Correction of heart arrhythmia using a catheter and a type of energy (such as heat) to destroy the source of the irregular rhythm 
  • Stent placement - Placement of small mesh wire devices to support abnormal blood vessels
  • Septal closures - The closure of an abnormal opening between the two upper chambers of the heart wall using closure devices
 
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