Catheterization Performed in the Early Postoperative Period After Congenital Heart Surgery in Children

Pediatric Cardiology - Tập 40 - Trang 827-833 - 2019
Ana María Eraso-Díaz del Castillo1,2, María Clara Escobar-Díaz1,2,3, Rafael Lince Varela1, Luis Horacio Díaz Medina1, Eliana Mabel Cañas Arenas2,4
1Pediatric Cardiology Department, Clínica Cardio VID, Calle 78B No. 75-21, Medellín, Colombia
2Universidad Pontificia Bolivariana, Medellín, Colombia
3Pediatric Cardiology Department, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain
4Research Department, Clínica Cardio VID, Medellín, Colombia

Tóm tắt

The aim of this study was to describe pediatric patients who underwent early postoperative cardiac catheterization after congenital heart surgery, their clinical indications, findings, interventions, and complications in a cardiovascular center. A descriptive retrospective study was performed. All catheterizations performed within 6 weeks after congenital heart surgery between January 2004 and December 2014 were reviewed. We analyzed 101 early postoperative catheterizations. They were performed on median postoperative day five (IQR: 0–39); the median age was 64 days (IQR: 22–240). The most common diagnoses were single ventricle (53%), left heart obstruction (12%), and tetralogy of fallot or pulmonary atresia with ventricular septal defect (11%). Most common indications were persistent cyanosis (53%), low cardiac output (24%), and residual defect on echocardiogram (20%). Most frequent findings during the catheterization were pulmonary artery stenosis (29%), surgical conduit obstruction (12%), and coarctation or hypoplasia of the aorta (11%). Forty-six (45%) procedures involved intervention. Most frequent interventions were pulmonary artery, aorta, and Blalock–Taussig fistula angioplasty with or without stent implantation. There were adverse effects in 11 cases (11%), and 30-day mortality was 28% (28 patients) with the majority unrelated to the catheterization directly. Although early postoperative catheterizations are high-risk procedures, they are currently a very good option to solve acute problems in critically ill patients. This study provides relevant information for a better understanding and approach to this complex group of patients.

Tài liệu tham khảo

Gatzoulis MA, Rigby ML, Redington AN (1995) Interventional catheterization in paediatric cardiology. Eur Heart J 16(2):1767–1772 Pihkala J, Nykanen D, Freedom RM, Benson LN (1999) Interventional cardiac catheterization. Pediatr Clin N Am 46(2):441–464 Van Aerschot I, Boudjemline Y (2012) Interventional cardiac catheterization in children. Arch Pediatr 19(1):96–102 Bergersen L, Gauvreau K, Foerster SR, Marshall AC, McElhinney DB, Beekman RH III et al (2011) Catheterization for congenital heart disease adjustment for risk method (CHARM). JACC Cardiovasc Interv 4(9):1037–1046 Zahn EM, Dobrolet NC, Nykanen DG, Ojito J, Hannan RL, Burke RP (2004) Interventional catheterization performed in the early postoperative period after congenital heart surgery in children. J Am Coll Cardiol 43(7):1264–1269 Yilmazer MM, Ustyol A, Guven B, Oner T, Demirpence S, Doksoz O et al (2012) Complications of cardiac catheterization in pediatric patients: a single center experience. Turk J Pediatr 54(5):478–485 Backes CH, Cua C, Kreutzer J, Armsby L, El-Said H, Moore JW et al (2013) Low weight as an independent risk factor for adverse events during cardiac catheterization of infants. Catheter Cardiovasc Interv 82(5):786–794 Odegard KC, Bergersen L, Thiagarajan R, Clark L, Shukla A, Wypij D et al (2014) The frequency of cardiac arrests in patients with congenital heart disease undergoing cardiac catheterization. Anesth Analg 118(1):175–182 Asoh K, Hickey E, Dorostkar PC, Chaturvedi R, van Arsdell G, Humpl T et al (2009) Outcomes of emergent cardiac catheterization following pediatric cardiac surgery. Catheter Cardiovasc Interv 73(7):933–940 Ma M, Gauvreau K, Allan CK, Mayer JE Jr, Jenkins KJ (2007) Causes of death after congenital heart surgery. Ann Thorac Surg 83(4):1438–1445 Siehr SL, Martin MH, Axelrod D, Efron B, Peng L, Roth SJ et al (2014) Outcomes following cardiac catheterization after congenital heart surgery. Catheter Cardiovasc Interv 84(4):622–628 Chaudhry-Waterman N, Coombs S, Porras D, Holzer R, Bergersen L (2014) Developing tools to measure quality in congenital catheterization and interventions: the congenital cardiac catheterization project on outcomes (C3PO). Methodist Debakey Cardiovasc J 10(2):63–67 Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN (1998) Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32(5):1433–1440 Cassidy SC, Schmidt KG, Van Hare GF, Stanger P, Teitel DF (1992) Complications of pediatric cardiac catheterization: a 3-year study. J Am Coll Cardiol 19(6):1285–1293 Kobayashi D, Sallaam S, Aggarwal S, Singh HR, Turner DR, Forbes TJ et al (2013) Catheterization-based intervention in low birth weight infants less than 2.5 kg with acute and long-term outcome. Catheter Cardiovasc Interv 82(5):802–810 Rhodes JF, Asnes JD, Blaufox AD, Sommer RJ (2000) Impact of low body weight on frequency of pediatric cardiac catheterization complications. Am J Cardiol 86(11):1275–1278 Simpson JM, Moore P, Teitel DF (2001) Cardiac catheterization of low birth weight infants. Am J Cardiol 87(12):1372–1377 desJardins SE, Crowley DC, Beekman RH, Lloyd TR (1999) Utility of cardiac catheterization in pediatric cardiac patients on ECMO. Catheter Cardiovasc Interv 46(1):62–67 Booth KL, Roth SJ, Perry SB, del Nido PJ, Wessel DL, Laussen PC (2002) Cardiac catheterization of patients supported by extracorporeal membrane oxygenation. J Am Coll Cardiol 40(9):1681–1686 Bhole V, Wright JG, De Giovanni JV, Dhillon R, Miller PA, Desai T et al (2011) Transcatheter interventions in the early postoperative period after the Fontan procedure. Catheter Cardiovasc Interv 77(1):92–98 Pitkin AD, Wesley MC, Guleserian KJ, Baum VC, Burch TM, Janelle GM (2013) Perioperative management of a patient with failed fontan physiology. Semin Cardiothorac Vasc Anesth 17(1):61–65 Zahn EM, Chang AC, Aldousany A, Burke RP (1997) Emergent stent placement for acute Blalock-Taussig shunt obstruction after stage 1 Norwood surgery. Cathet Cardiovasc Diagn 42(2):191–194 Walayat M, McArthur K, Lilley S, Wilson N (2003) Feasibility and safety of immediate perioperative implantation of intravascular stents in cavopulmonary pathways. Catheter Cardiovasc Interv 60(1):94–98. (discussion 99-100) Feltes TF, Bacha E, Beekman RH III, Cheatham JP, Feinstein JA, Gomes AS et al (2011) Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 123(22):2607–52 Nicholson GT, Kim DW, Vincent RN, Kogon BE, Miller BE, Petit CJ (2014) Cardiac catheterization in the early post-operative period after congenital cardiac surgery. JACC Cardiovasc Interv 7(12):1437–1443 Kasar T, Cansaran Tanidir I, Ozturk E, Kafali C, Sahin M et al (2018) Cardiac catheterization in the early post-operative period after congenital heart surgery. Acta Cardiol Sin 34(6):481–487 Nykanen DG, Forbes TJ, Du W, Divekar AA, Reeves JH, Hagler DJ et al (2016) CRISP: catheterization RISk score for pediatrics: a report from the congenital cardiac interventional study consortium (CCISC). Catheter Cardiovasc Interv 87(2):302–309 Boscamp NS, Turner ME, Crystal M, Anderson B, Vincent JA, Torres AJ (2017) Cardiac catheterization in pediatric patients supported by extracorporeal membrane oxygenation: a 15-year experience. Pediatr Cardiol 38(2):332–337 Callahan R, Trucco SM, Wearden PD, Beerman LB, Arora G, Kreutzer J (2015) Outcomes of pediatric patients undergoing cardiac catheterization while on extracorporeal membrane oxygenation. Pediatr Cardiol 36(3):625–632 Panda BR, Alphonso N, Govindasamy M, Anderson B, Stocker C, Karl TR (2014) Cardiac catheter procedures during extracorporeal life support: a risk-benefit analysis. World J Pediatr Congenit Heart Surg 5(1):31–37 Rosales AM, Lock JE, Perry SB, Geggel RL (2002) Interventional catheterization management of perioperative peripheral pulmonary stenosis: balloon angioplasty or endovascular stenting. Catheter Cardiovasc Interv 56(2):272–277