Indications for cardiac catheterisation in GUCH

Indications for cardiac catheterisation in GUCH

The role for cardiac catheterisation in grown up congenital heart disease or GUCH has come down remarkably with the wide availability of echocardiography, cardiac magnetic resonance imaging and computed tomography. Still there are some reasons to go for a cardiac cath in congenital heart disease. When non invasive assessment has shown a pulmonary artery systolic pressure above 50 mm Hg, there is a role for cath to assess the pulmonary vascular resistance in shunt lesions.

Pulmonary vasoreactivity can also be tested to assess the reversibility of pulmonary hypertension, with oxygen or nitric oxide, the latter being preferable now. Ventricular function, pressure gradient and shunt quantifications may be additional roles for cardiac cath when the non invasive values are equivocal. The need for coronary angiography in men over forty years and post menopausal women going for cardiac surgery and in those with signs or risk factors for coronary artery disease is another potential role. Angiography is also useful in the evaluation of collaterals.