Precautions for cardiac catheterization in a cyanotic child

Precautions for cardiac catheterization in a cyanotic child Pediatric diagnostic cardiac catheterizations have come down with the availability of better imaging modalities which can give most of the details needed for management non-invasively. Still cardiac catheterization may still be needed in selected cases, leave alone the catheterization prior to pediatric cardiac interventions. Cyanotic child presents more challenges during cardiac catheterization, mostly due to the presence of hypoxia and polycythemia. Hospitalization on the previous day will be desirable along with 3-4 hour fasting prior to procedure. As there is a chance for hemoconcentration during fasting, adequate hydration by intravenous route is needed. Hemoconcentration increases the chance of stroke in cyanotic children. Attention to oxygen saturation during procedure is needed as the procedures are often done under deep sedation. Total contrast used for angiography should be limited to less than 3-4 ml/Kg [1]. Important reasons for cardiac catheterization in cyanotic congenital heart diseases are as follows: Assessment of pulmonary arterial anatomy including size, confluence, any stenosis at the origin of vessels and peripheral pulmonary stenosis. Assessment of pulmonary arterial pressures Assessment of aortopulmonary collaterals Assessment of post operative cases for pulmonary arterial pressures and to look for any distortion due to surgery Assessment of coronary anomalies [2]. Post procedure monitoring i...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Source Type: blogs