【Major Points】

1. Fasting for at least 4-8 hours and proper skin cleansing are required before cardiac catheterization.
2. After the examination, the child must lie flat. The limb used for the puncture must be kept straight and not bent, and a sandbag should be applied with pressure on the puncture site.
3. When the child wakes up, offer a small amount of water first. If there is no nausea or vomiting, food can be introduced gradually.
4. After the examination, the child should be closely monitored for signs of infection. If any abnormalities occur, please return to the hospital for further evaluation immediately.

 

What is a cardiac catheterization?

Cardiac catheterization refers to the delivery of a cardiac catheter to the heart through the femoral vein or femoral artery to examine the structures and functions of the heart and blood vessels, in order to provide the basis for further diagnosis and treatment.

 

Why do you need to take a cardiac catheterization?

1. The doctor will explain the purpose, procedure, and potential risks to the parents, and they must sign the informed consent form before the examination.
2. According to the child's cognitive development, explain to the child and family the purpose and process of cardiac catheterization, the reason for fasting (e.g., food, water, and milk), the location of the wound after the examination, and the purpose of applying a sandbag.
3. The child must fast for at least 4–8 hours before cardiac catheterization (including food, water, and milk) to prevent aspiration pneumonia caused by vomiting during the procedure.
4. When taking a bath the night before the examination, make sure to clean both sides of the groin area thoroughly.

1. After receiving the notice from the cardiac catheterization room, the nurse will ask your child to empty the bladder or change the diaper. A staff member will take your child to the cardiac catheterization room, and you can go with them.
2. The doctor will administer general anesthesia before the cardiac catheterization to relieve discomfort and fear.
3. Physiological monitors will be used throughout the entire procedure to monitor heart rate, respiratory rate, and oxygen saturation.
4. After the child falls asleep, the doctor will insert the cardiac catheter through the femoral vein or femoral artery, inject contrast medium at the appropriate site, examine the structures and functions of the heart, or perform necessary treatments.
5. The duration of the examination will depend on the child’s condition, and is usually approximately 1 to 2 hours. During the examination, please wait outside and do not leave, as the doctor may explain the child’s condition or discuss further treatment options with you at any time.

What to expect after cardiac catheterization?

1. After the cardiac catheterization, the child should lie flat for approximately 6–8 hours. The puncture site is usually compressed with a sandbag for 2–4 hours. Please keep the limb on the side of the puncture straight and avoid bending it to prevent bleeding.
2. Within 24 hours after the examination, avoid excessive movement of the limb that was used for the procedure to prevent bleeding. If your child becomes fussy, do your best to calm and comfort them.
3. When the child is awake, encourage them to drink some water. If there is no nausea or vomiting, food can be given gradually.
4. Twenty-four hours after cardiac catheterization, the nurse will change the dressing at the puncture site.

1. After discharge, keep the wound clean and dry. Clean the child with a damp towel. Showering may begin two days after the procedure. The child should not take a tub bath until the wound is completely healed.
2. Bruising may appear around the wound area and usually resolves within a few days. If the bruise gradually enlarges, please take your child to the pediatric cardiology clinic right away.
3. If the wound is bleeding, immediately press on the wound with a clean, dry cloth for 3–4 minutes. If the bleeding continues, please seek medical attention right away.  
4. If any abnormal conditions occur, such as redness and swelling of the wound, fever above 38 °C, or pale, painful, or numb limbs, please seek medical attention immediately.
5. If a vascular stent or occluder is placed during this procedure, avoid striking or patting the chest or back forcefully to prevent loosening.

1. Aktiz-Bıçak, E., Kılıç, Y., Elmastaş, D., Bıçak, M., Aldudak, B., & Salık, F. (2023). Comparison of ultrasound guidance and palpation technique for femoral artery catheterization in children undergoing cardiac surgery. Cirugiay Cirujanos, 91(5), 633–640. https://doi.org/10.24875/CIRU.23000112
2. Avila, M. L., Shah P. S., & Brandão, L. R. (2020). Different unfractionated heparin doses for preventing arterial thrombosis in children undergoing cardiac catheterization. Cochrane Database of Systematic Reviews, (2). https://doi.org/10.1002/14651858.CD010196.pub3
3. Bansal, N., Misra, A., Forbes, T. J., & Kobayashi, D. (2021). Femoral artery thrombosis after pediatric cardiac catheterization. Pediatric Cardiology, 42, 753-761.https://doi.org/10.1007/s00246-020-02537-2