What is a Cath? & Photos from the Room

As previously reported, Zoe Madison must be at CHOP at 7:30 a.m. on Monday for her cardiac catheterization.

Many of you already know, too well, the intimate details of a cardiac catheterization. For those of you, however, who have not undergone a cath, as they are referred to in the biz, or haven't had a heart baby/child go through one, below is an explanation of the procedure and its purposes.

What is cardiac catheterization?

Cardiac catheterization is a procedure that involves puncturing an artery and/or vein, usually located in the groin, so that a small, long, flexible tube (catheter) can be guided into the heart and major vessels around the heart.

The catheter is moved through the heart with the aid of fluoroscopy (x-ray machine). This is usually performed to help in providing a diagnosis of heart problems.

With cardiac catheterization, pressure measurements and blood samples can be obtained from the various cardiac chambers and blood vessels around the heart allowing calculations of detailed information about the heart's function.

X-ray dye can also be injected through the catheters giving pictures of structures in and around the heart.

Why catheterization is helpful?

In addition to obtaining measurements and pressures, catheterization can be used to perform interventional procedures.

Interventional catheterization is a type of cardiac catheterization where actual treatments can be performed by use of specialized catheters. The types of treatments performed are varied and are individualized to each patient. Most commonly, interventions are used in certain cases where there are narrowed valves or arteries causing obstruction of blood flow.

These specialized catheters include balloon catheters that can open up narrowed valves or arteries and also catheters where devices can be deployed which can close extra vessels or certain "holes" in the heart. This is how Zoe's stents were placed in her shunt during her post-Norwood cath.

In Zoe's case, the cath will also give Dr. Spray a clear picture, complete with measurements and pressures of Zoe's heart and lungs so he can know, before her chest is cut open, precisely what her heart looks like which will allow him to plan the precise steps of Zoe's surgery.

Zoe's Cath

Since this is Zoe's pre-Glenn cath, and her Glenn is the following day, she will more than likely not receive any intervention. If a problem is discovered it will be addressed during the Glenn surgery. As we said, this is more of an informational, exploratory procedure to gather information for Dr. Spray.

From her first cath, Zoe developed a blood clot in her left femoral artery. The veins and arteries of an infant are so small, it's not uncommon for a blood clot to develop, at that age, as the result of a cath procedure. This is why Zoe underwent a leg ultrasound on Friday, the interventional cardiologist handling her case wanted to see the current stage of the blood clot. The clot could affect the integrity of the entry point in the left leg. If it is compromised, for entry purposes, there are other entry options, i.e. other leg, neck, or chest. This will all be determined Monday morning.

Until the cath, we are hanging out in the room, taking pics of Zoe and our surroundings. Here's a few pics to enjoy:

(CHOP and the other U Penn hospitals in the background)

(A view of Center City Philly from our room)

(Zoe relaxing)

(Aren't I cute?!)