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Early complications of interventional balloon catheterisation in infants and children
P Booth1, A N Redington, E A Shinebourne
1Department of Paediatric Cardiology, Royal Brompton and National Heart Hospital, London.
Insights
Balloon intervention for congenital heart defects had a 24% complication rate, with vascular issues being most common. Complications were higher in neonates and unsuccessful procedures but generally transient.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Interventional balloon catheterization is a primary treatment for various congenital heart defects.
- Assessing complication rates is crucial for evaluating the safety of these pediatric cardiac interventions.
Purpose of the Study:
- To determine the overall complication rate of interventional balloon catheterization in children.
- To identify factors associated with higher complication risks in pediatric cardiac procedures.
Main Methods:
- Retrospective analysis of 160 children undergoing balloon intervention (excluding balloon atrial septostomy) at Brompton Hospital.
- Data collection included complication types, patient demographics, and procedure outcomes.
Main Results:
- The overall complication rate was 24%, decreasing to 14% when excluding hemorrhage.
- Vascular complications at the catheterization site were the most frequent issue.
- Complications were more prevalent in younger patients (especially neonates) and with unsuccessful procedures.
- Three deaths (1.9%) occurred, and most complications were transient with no long-term effects.
Conclusions:
- Interventional balloon catheterization for congenital heart defects carries a manageable complication rate.
- Younger age and procedural failure are risk factors for complications.
- Ongoing improvements in equipment and technique are expected to further reduce morbidity.
Abstract:
Interventional balloon catheterisation is now the recommended procedure for several congenital heart defects. The overall complication rate in the first 160 children (median age 3 years) to undergo balloon intervention (excluding balloon atrial septostomy) at the Brompton Hospital was 24% (14% excluding haemorrhage and including three deaths (1.9%]. Most complications were related to vascular problems at the site of cardiac catheterisation. Complications were more common in the younger patient, especially neonates, and also in procedures that were ultimately unsuccessful. Most complications were transient and usually had no long term effects. Improvements in equipment design and technical expertise may reduce morbidity from these procedures.