Interventional cardiac catheterization has transformed the field of congenital cardiology by giving cardiac physicians the ability to treat certain types of heart problems in a minimally invasive manner. Cardiac catheterization was initially a diagnostic procedure, but has evolved into a therapeutic approach, often complementing surgery. The Interventional Catheterization Program embraces both surgical and interventional approaches and uses aspects of both types of procedures when formulating the best overall long-term plan for a case.
Additionally, catheterization with surgery, also known as a hybrid procedure (the combination of catheter-based interventions with surgical techniques performed during the same procedure) is conducted in our dedicated pediatric hybrid lab. Joe DiMaggio Children's Hospital Heart Institute is the only children's hospital in Broward County performing pediatric cardiac catheterization.
With more than 50 years of combined experience in the field, the team is led by two top internationally acclaimed interventionists. Those leaders are Larry Latson, MD, a pioneer in interventional cardiology and an expert in minimally invasive valve replacement and catheterization techniques for treatment of congenital heart disease, and Kak-Chen Chan, MD, who is also a pioneer in interventional cardiology and has expert knowledge of the congenital cardiac anatomy of infants and children. Both can perform cardiac catheterization procedures on the tiniest of hearts or on adults with complex congenital or structural cardiac defects. Both remain active in research on new devices and procedures for interventional catheterization.
How Cardiac Catheterization Procedures Work
A catheter is a thin, flexible, hollow tube that can be inserted into the blood vessels and advanced into the patient's heart and major arteries and veins. The cardiologist gently guides the catheter on its journey, using fluoroscopic imaging to help “see” and record information about the patient's cardiovascular system. This diagnostic catheterization allows the doctor to find the type of heart defect, the exact place and how severe it is. If an intervention is to be done, a specialized catheter or device can be delivered from the same approach.
When Are Cardiac Catheterization Procedures Used?
There are two types of cardiac catheterization procedures—diagnostic and interventional.
A diagnostic catheterization helps physicians gather information about the heart and its blood vessels by allowing doctors to:
- Evaluate congenital heart defects (heart defects that are present from birth)
- Measure the blood pressure inside the heart
- Measure the amount of oxygen in the heart
- Check for problems with heart valves
- Locate narrowed or blocked blood vessels
- Determine the need for further treatment or surgery
- Obtain tissue samples for biopsy
Interventional Cardiac Catheterization
Interventional cardiac catheterization uses interventional techniques to treat cardiac defects, avoiding surgery when possible. Heart conditions that can be treated using an interventional catheterization, include:
- Closing some holes inside the heart
- Repairing narrow heart valves or arteries
- Placing a new valve in certain conditions
In more complex cases, interventional procedures can be used to keep the patient safe and stable until they are physically big enough for surgery or until the time is right for a surgical intervention. In rare situations, patients are referred to us for surgery who are unstable. In these cases, cardiac catheterization can be used as a lifesaving, rescue intervention.
Advantages of Cardiac Catheterization Procedures
Newborn babies, in particular, have benefited greatly from the availability of catheter-based procedures in the treatment of congenital heart defects, since they are so fragile. Some of the advantages of cardiac catheterization procedures include:
- It is less invasive and traumatic than major surgery and generally has fewer risks
- It is far less painful, with patients typically requiring only light anesthesia and a local anesthetic
- A child's recovery time is shorter than with surgery and they usually experience less scarring
- It avoids cardio-pulmonary bypass
Hybrid Procedures: Combining Catheterization with Open Heart Surgery
Congenital heart conditions are varied and complex. In some cases, patients may undergo hybrid procedures that combine surgical and interventional procedures. Our dedicated pediatric hybrid suite is capable of supporting procedures that combine catheterization with surgery, including:
- Hybrid palliation of single ventricle (such as hypoplastic left-heart syndrome)
- Er-ventricular closure of cardiac defects
- Intraoperative placement of stents
- Ability to take an angiogram (to check a repair before closing the chest)
Melody® Transcatheter Pulmonary Valve Replacement
Joe DiMaggio Children's Hospital Heart Institute offers new hope for patients born with heart defects. Its team of world-class doctors includes internationally renowned interventional cardiologist Larry Latson, MD, one of the first physicians certified in the United States after FDA approval of Melody® Transcatheter Pulmonary Valve Replacement—a revolutionary, non-surgical alternative to open heart surgery. The Melody® valve replaces blocked or leaky pulmonary heart valves and helps patients of all ages who might otherwise need multiple open heart surgeries in their lifetime.
Clinical trials for surgical valves and interventional devices for atrial septal defect (ASD) and ventricular septal defect (VSD) are ongoing at the Heart Institute. Newer studies designed to treat adult cardiac patients who might be at risk for pulmonary hypertension, and ways to better treat heart defects, migraines and even prevent strokes are also being developed.
Our lab is part of a study that makes available a specialized covered stent, which can be used in case of emergency in the catheterization lab.