Published: Nov. 29, 2011
Updated: Nov. 29, 2011
A review of cardiac catheterization
Not very long ago children with congenital heart disease had few treatment options. Thankfully, that is no longer the case.
Duke pediatric cardiologist Gregory A. Fleming, MD, MSCI, explains exciting research in interventional cardiology and how that translates to treatments for children.
-- Dennis Clements MD, PhD, MPH
A diagnostic cardiac catheterization is a procedure in which small, flexible catheters are inserted through veins or arteries into the heart to measure oxygen levels and pressures in chambers of the heart as well as inject a special dye into the heart to visualize the structures of the heart under x-ray (fluoroscopy).
The purpose of a diagnostic catheterization is to obtain information to help guide further treatment.
Interventional cardiology refers to interventions performed by a cardiologist during a cardiac catheterization procedure to fix or stabilize certain problems within the heart or within blood vessels of the heart.
Interventions are commonly performed on adults with blockage of the coronary arteries (the blood vessels that supply the heart muscle with oxygen) to prevent heart attacks. These interventions usually consist of dilating the coronary arteries with special balloon catheters and sometimes placing a metal stent into the narrowed portion of the coronary artery.
Interventions in children are usually different than those performed in adults. In children, many different types of interventions are performed to fix or stabilize malformations or birth defects of the heart (Congenital Heart Defects) that can occur during development of the heart.
Numerous devices have been specially engineered to close abnormal blood vessel connections and abnormal holes between chambers of the heart. These devices are released into the heart through the catheters that are inserted into the veins and arteries.
Some common interventions in children that have been performed for many years are:
Exciting research is ongoing in the field of interventional pediatric cardiology. Some of this research has resulted more recently in the following:
Some examples of newer applications of interventional cardiology in children are:
Those are a few of the many new opportunities that exist for children with heart disease. It is an exciting time for research in this area, and we expect that more advances will come to fruition in the coming years.
-- Gregory A Fleming, MD, MSCI, is a pediatric cardiologist in the Duke Department of Pediatrics.
-- Dennis Clements, MD, PhD, is the chief of primary care pediatrics at Duke Children's Hospital.