ABSTRACT
This chapter deals with diagnostic cardiac catheterization in the child with congenital cardiac disease. However, in actual clinical practice, the catheterization laboratory requires that the physician recognize unanticipated indications for intervention that may become evident during the course of a diagnostic catheterization and that he or she can perform these interventions when necessary. Therefore, the chapter discusses the following areas that are important when performing a cardiac catheterization in a pediatric patient: sedation for the procedure, vascular access, hemodynamic assessment, and angiography. In both adult and pediatric catheterization laboratories, pressures are usually measured with fluid-filled catheters. The chapter also discusses percutaneous transthoracic puncture which can be used to obtain access to the ventricles in a patient with a mechanical valve in the aortic and mitral, or tricuspid position. The hepatoclavicular projection is helpful to evaluate defects in the posterior trabecular septum, apical septum, and around the atrioventricular valves.
