Pediatric Cardiac Catheterization
Diagnostic and interventional catheterization for congenital heart disease — ASD/VSD/PDA closure, balloon valvuloplasty, stent placement in coarctation or conduits, pulmonary artery interventions, hybrid procedures. Distinct discipline from adult cath: smaller patients (neonates to adolescents), different anatomy (biventricular physiology to Fontan circulations), heightened dose sensitivity.
Clinical pathway
Highly variable by lesion — PDA coil closure, ASD device closure (Amplatzer), pulmonary valvuloplasty for critical PS in neonate, RV-PA conduit stenting in Tetralogy variants. Typical: femoral venous ± arterial access, hemodynamics, angiography with biplane cine, device deployment with TEE guidance.
Typical systems
Biplane nearly universal in pediatric cath — reduces contrast and dose burden critically in small patients.
Room + procedure characteristics
- Procedure time: 60 min (simple PDA) to 6+ hours (complex Fontan completion hybrid)
- Team: pediatric interventional cardiologist, pediatric anesthesia, echo cardiologist (intraprocedural TEE), pediatric nursing
- Dose: strict pediatric dose protocols, spectral beam shaping, tight collimation, pulsed fluoro at low rates; size-adjusted reference air kerma tracked
Dose considerations
Lifetime cancer risk per unit dose is higher in children — every pediatric cath lab tracks size-adjusted DAP and has pediatric preset protocols (often vendor-specific dose reduction packages mandatory rather than optional).