[Anesthetic management in pediatric interventional cardiology]

Interventional cardiology (n = 108) and cardiac angiography (n = 481) procedures in pediatrics performed between January 1996 and December 1998 were reviewed. Means (SD) of duration of anesthesia for interventional cardiology and cardiac angiography were 245 (130) and 152 (48) minutes, respectively (P < 0.001). Incidences of long operations requiring over 6 hours of anesthesia were 12 and 0%, respectively (P < 0.001). Incidences of hemodynamic derangements were 17 and 2.9%, and catheter-related complications were 7.4 and 0.83%, respectively (P < 0.001). Incidences of ICU admission were 7.4 and 0.62% those of emergency surgery were 4.6 and 0%, and those of blood transfusion were 4.6 and 0%, respectively (P < 0.001). Incidences of cardiopulmonary resuscitation, and cardioversion were also higher in interventional cardiology (P < 0.05), and all these emergency cases were rescued successfully. The risk of cardiac angiography is higher compared with general surgery, and the risk of interventional cardiology is higher than cardiac angiography in pediatrics. This study reconfirms that anesthesiologists should play an active role in care of pediatric patients undergoing high-risk procedures outside the operating room.