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The catheterization laboratory performs diagnostic examinations and contrast studies of the circulation, procedural catheterizations, arrhythmia tests and treatments and installations of pacemakers. As other examination methods such as ultrasound examinations, CTs and MRI studies have been developed, the number of diagnostic catheterizations has decreased. As the technology and equipment have developed, the number of pediatric procedural catheterizations and catheterization treatments for arrhythmia have increased notably over the last 10–15 years. Pediatric heart catheterizations have been centralized at New Children’s Hospital, where approximately 480 catheterizations are performed annually.
Some pediatric structural heart defects can be treated with the catheterization technique without surgery. Procedural catheterization can be used to close shunts such as atrial septal defects, patent ductus arteriosus or other abnormal venous connections that overload the circulation. A septal occluder is inserted in place through a catheter inserted via the groin and taken to the location along a vein. Stenotic valves or veins can be expanded with balloon catheters. Nowadays, the size of balloon catheters is so small that even newborns weighing 1.5 kg can be treated with this method. In some cases, the balloon catheter can be used to place a stent in a narrowed vein to open the constriction and prevent the vein from becoming stenotic again.
The catheter technique can also be used to examine and treat rapid arrhythmias. First, the mechanism of the arrhythmia is clarified with an electrophysiological study, after which the structure maintaining the arrhythmia can be destroyed by heating or cooling it with the help of the catheter. Over the last few years, pacemaker treatments have developed considerably. A pacemaker is used to treat patients with an overly slow heart rate, an arrhythmia pacemaker for patients with life-threatening rapid arrhythmias, and a heart failure pacemaker for patients suffering from a heart contraction disorder and cardiac insufficiency. In most cases, these devices are installed in a catheterization laboratory by taking the pacemaker wires in the heart via the veins.
In catheterizations, the number of complications is smaller and children recover from the procedure more quickly than from corresponding cardiac operations. Usually the children are admitted to hospital on the day before the procedure and discharged the day after, and can return to normal activities immediately.