Cyanosis other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Amandeep Singh M.D.[3]


Cardiac catheterization is an invasive study for the anatomic and physiological assessment of patients with cyanotic congenital heart disease

Cardiac catheterization

Cardiac catheterization is the gold standard for the anatomic and physiological assessment of patients with cyanotic congenital heart disease when determining of the anatomy of congenital heart disease is inadequate by noninvasive imaging.[1]

Cardiac Catheterization

Recommendations for catheterization in congenital heart disease
(Class I, Level of Evidence A):

❑ Obtaining hemodynamic and anatomic data at the time of intervention

(Class I, Level of Evidence B) :

❑ Assessment of pulmonary resistance and reversibility of pulmonary hypertension in patients with CHD or primary pulmonary hypertension for surgical procedure or medical decisions
❑ Assessment of complex pulmonary atresia for determination of lung segmental pulmonary vascular supply, especially when noninvasive imaging are inadequate
❑ Determination of coronary circulation in pulmonary atresia with intact septum
❑ Follow-up of graft vasculopathy after cardiac transplantation

(Class I , Level of Evidence C)

❑ Assessment of patient before cardiac transplantation

(Class 2a, Level of Evidence B)

❑ Determination of pulmonary pressure/resistance and transpulmonary gradient in palliated single-ventricle patients before a staged Fontan procedure
❑ Assessment of cardiomyopathy or myocarditis
❑ Assessment of suspected congenital coronary artery anomalies

(Class 2a, Level of Evidence C)

❑ In any CHD patient in whom complete diagnosis and information cannot be obtained by noninvasive testing
❑ Assessment of anatomy and hemodynamics in postoperative cardiac patients when the early postoperative course is unexpectedly complicated and noninvasive imaging techniques ( cardiac MRA, cardiac CT angiography) fail to diagnose


  1. Feltes, Timothy F.; Bacha, Emile; Beekman, Robert H.; Cheatham, John P.; Feinstein, Jeffrey A.; Gomes, Antoinette S.; Hijazi, Ziyad M.; Ing, Frank F.; de Moor, Michael; Morrow, W. Robert; Mullins, Charles E.; Taubert, Kathryn A.; Zahn, Evan M. (2011). "Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease". Circulation. 123 (22): 2607–2652. doi:10.1161/CIR.0b013e31821b1f10. ISSN 0009-7322.