Your Child’s Experience: Cardiac Catheterization for Coarctation of the Aorta (COA)
Cardiac catheterization is a procedure done on the heart using a thin, flexible tube (catheter). It’s done by a cardiologist specially trained to treat heart problems using these catheters. The procedure lasts about 2 to 4 hours. It takes place in a catheterization laboratory. You’ll stay in the waiting room during the procedure.
Before the procedure. You’ll be told whether to keep your child from eating or drinking anything for a certain amount of time before the procedure. Follow these instructions carefully.
During the procedure. Your child is given medicine (sedative or anesthesia) to help him or her relax and not feel pain during the procedure. A breathing tube may be placed in your child’s trachea (windpipe). Special equipment monitors your child’s heart rate, blood pressure, and oxygen levels. The catheter is inserted into an artery in the groin. With the help of live X-rays, the catheter is advanced up through the artery to the aorta where the defect is. Contrast dye may be injected through the catheter. The dye allows the inside of the aorta to be seen more clearly on X-rays. A balloon at the end of the catheter is used to widen the narrowed area. A wire mesh tube (stent) may also be placed to prevent narrowing from occurring again. Once the narrowed area has been widened, the catheter and balloon are removed.
After the procedure. Your child is taken to a recovery room. You can be with your child during much of this time. It may take several hours for the medicine to wear off. Pressure is applied to the catheter insertion site to limit bleeding. The doctor or nurse will tell you how long your child needs to lie down and keep the insertion site still. Your child is cared for and monitored until he or she can leave the hospital. An overnight hospital stay is usually required after this procedure.
Risks and complications of cardiac catheterization
Reaction to contrast
Reaction to sedative or anesthesia
Pain, swelling, redness, bleeding, or drainage at the catheter insertion site
Abnormal heart rhythm
Injury to the heart or a blood vessel
Some narrowing remains and additional surgery may be needed
When to call the doctor
After cardiac catheterization procedure, call the doctor right away if your child has any of the following:
Increased redness, draining, swelling, or bleeding at the incision or insertion site
Fever 100.4°F (38°C) or higher, or as advised
Shortness of breath or trouble breathing
Cough that won’t go away
Nausea or vomiting that continues
What are the long-term concerns?
After repair of COA, most children can be active and participate in sports and other physical activities.
Regular follow-up visits with the cardiologist are needed. The frequency of these visits may decrease as your child grows older. COA may reoccur over time. Further treatment may be needed when your child is older.
Medicines may be prescribed to treat problems such as high blood pressure. This is common in children with a history of COA (usually older children).
Your child may need to take antibiotics before having any surgery or dental work for 6 months after the procedure. This is to prevent infection of the inside lining of the heart or valves. This infection is called infective endocarditis. Antibiotics should be taken as directed by the cardiologist.
August 17, 2018
Management of coarctation of the aorta, Up To Date
Ayden, Scott, MD,Bass, Pat F. III, MD, MPH