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Complications of pediatric cardiac catheterization: a review in the current era
Rohit Mehta1, Kyong-Jin Lee, Rajiv Chaturvedi
1The Hospital for Sick Children, Department of Pediatrics, The Labatt Family Heart Center, The University of Toronto School of Medicine, Toronto, Canada.
Insights
Pediatric cardiac catheterization has risks, with vascular complications being most common. Young age, male gender, and inpatient status are key risk factors for complications and mortality.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Pediatric cardiac catheterization is a vital diagnostic and therapeutic procedure.
- Despite technological advancements, complications can still negatively impact patient outcomes.
Purpose of the Study:
- To identify the types and risks of complications associated with pediatric cardiac catheterization.
- To analyze trends and risk factors in the current era of the procedure.
Main Methods:
- Retrospective review of clinical records for 11,073 children undergoing cardiac catheterization from January 1994 to March 2006.
- Data collection included demographic, procedural, and treatment information to identify complications within 24 hours post-procedure.
Main Results:
- A total of 858 complications (7.3%) were recorded, with 195 major and 663 minor.
- Vascular complications were most frequent (32.4%), and 25 deaths (0.23%) occurred within 24 hours.
- Risk factors for complications included younger age (<6 months), male gender, inpatient status, and year of catheterization.
Conclusions:
- Complications persist in pediatric cardiac catheterization, though the overall incidence may be decreasing.
- Younger age, male gender, and inpatient status remain significant risk factors for morbidity and mortality.
- Improvements in equipment flexibility, size, and alternative access methods are recommended to mitigate risks.
Objective:
To determine types of complications and risks associated with pediatric cardiac catheterization in the current era.
Background:
Pediatric cardiac catheterization is an important diagnostic and therapeutic tool. Although in the last decade, there have been significant improvements in technology and equipment, the risk for complications remains, adversely effecting outcomes.
Design:
The clinical records of 11,073 children undergoing cardiac catheterizations between January 1994 and March 2006 were reviewed to identify procedures associated with complications within the first 24 h after catheterization. All children's electronic and paper chart records were reviewed to obtain demographic, procedural, and treatment data.
Results:
A total of 858 (7.3%) complications (classified as major or minor) occurred in 816 studies (510 males, 63%), in children ranging in age from 8 h to 20 years (median 4.13 years). There were 195 major (22%) and 663 (78%) minor complications. Vascular complications represented the majority (n = 278; 32.4%) and were major in 53 instances (P < 0.0001). Twenty-five children died within 24 h (0.23% of total case numbers). Independent risk factors for a complication included young patient age (<6 months), male gender, inpatient status, and year of catheterization.
Conclusions:
Complications continue to be associated with pediatric cardiac catheterization, although overall incidence appears to be decreasing. Patient age, gender, and inpatient status continue to be risk factors for morbidity and mortality. Efforts at improving equipment for flexibility and size, and developing strategies for the use of alternative methods for catheter access should be encouraged.
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