Pediatric Cardiac Catheterization
Cardiac catheterization is rarely performed as a diagnostic procedure for children, since most of the structural and functional heart diseases are diagnosed by echocardiography. Some catheterizations are performed to assess hemodynamics before surgery. In the majority of cases, the baby or the child will be referred for a transcutaneous procedure such as coil closure of a patent ductus arteriosus (PDA), device closure of an atrial septal defect (ASD), or creating a communication through the interatrial septum in case the newborn has transposition of great arteries.
Intra-operative and Intra-catheterization
Transesophageal Echocardiography (TEE). TEE is performed during surgical or transcutaneous therapeutic intervention in the catheterization laboratory to provide on-line imaging of the heart.
Pregnant women who carry a fetus with a suspected cardiac defect, with a history of cardiac defects in the family, and those with specific systemic diseases such as Diabetes Mellitus or Systemic Lupus Erythematosus, are referred to this clinic to undergo fetal echocardiography. The examination is typically performed between the 17th and the 22nd week of gestation. However, in some cases where the development of a cardiac defect is highly suspected, fetal echocardiography will be performed at the 14th week of gestation. In rare cases, transvaginal fetal echocardiography will be performed even earlier, in the 11th week of gestation.
Newborns, infants and children who appear to suffer from heart disease are examined by echocardiography to determine if they carry a cardiac defect.
Pediatric Exercise Test
Similar to the adult exercise test, this test is performed with an age-adjusted target heart rate. In contrast to adults, the indication to perform this test in children is usually not ischemic heart disease, but to assess the cardiac function after surgery or to investigate a cardiac arrhythmia during effort.
In children, 24-hour ECG monitoring is mainly used to assess a congenital or acquired arrhythmia.