Complications and mortality associated with cardiac catheterization in infants under one year: A prospective study

To evaluate complications and mortality following cardiac catheterization (CC) in patients under one year of age, we prospectively examined 312 CC on 273 patients from the centers in the New England Regional Infant Cardiac Program during a one-year period. Among CC performed on patients less than four months old, the incidence of complications requiring treatment was 12%; for patients 4–12 months, it was 1.5% (p<0.02). By pre-CC risk assessment, 13% of CC were high risk, 21% medium risk, and 66% low risk. The incidence of major complications was much greater among the High Risk (30%) compared with Medium Risk (14%) (p<0.05) and with Low Risk (4%) (p<0.001). The overall mortality rates 24 h, 48 h, and one week after CC were 3.8%, 8.3%, and 13.5%, including patients with inoperable lesions and those having cardiac surgery, while deaths directly attributable to a CC complication were 0, 0.3%, and 0.3%, respectively. We can predict, prior to CC, the high-risk cases where major complications and death are likeliest to occur. The incidence of death from CC-related complications is extremely low in patients under one year of age, compared with death from the underlying lesion or following cardiac surgery.