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Published on: July 18, 2014
Outcomes following cardiac catheterization after congenital heart surgery
Stephanie L Siehr1, Mary Hunt Martin, David Axelrod
1Department of Pediatrics, Cardiovascular Institute, Stanford University School of Medicine, Palo Alto, California.
Insights
Unplanned cardiac catheterization after congenital heart surgery can significantly alter patient management, with 69% of procedures leading to changes in treatment. Complications associated with this procedure are rare, highlighting its safety and utility.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Interventional Cardiology
Background:
- The role of cardiac catheterization after congenital heart surgery is not well-established.
- Limited research exists on the outcomes of unplanned cardiac catheterization in this patient population.
Purpose of the Study:
- To describe the outcomes of unplanned cardiac catheterization in patients who have undergone congenital heart surgery.
- To evaluate the diagnostic and therapeutic impact of these procedures.
Main Methods:
- Retrospective analysis of 150 unplanned cardiac catheterizations in 120 patients from October 2004 to April 2011.
- Examined patient demographics, indications for catheterization, and clinical outcomes.
- Assessed changes in management and complication rates.
Main Results:
- Survival at 30 days post-catheterization was 85%, with 72% survival to hospital discharge.
- Indications included hemodynamic evaluation (63), intervention (46), and surgical repair assessment (41).
- 69% of procedures led to a change in management, including interventions, re-operations, and medication adjustments.
Conclusions:
- Unplanned cardiac catheterization after congenital heart surgery can lead to significant diagnostic and therapeutic changes.
- The procedure is associated with a low rate of complications.
- It plays a valuable role in optimizing clinical and surgical management for these complex patients.
Objectives:
Describe outcomes following unplanned cardiac catheterization after congenital heart surgery.
Background:
Utility of cardiac catheterization following congenital heart surgery is relatively understudied.
Methods:
Retrospective study examining demographics, indications, and outcomes of unplanned cardiac catheterization after congenital heart surgery at a single institution.
Results:
Between October 2004 and April 2011, 120 patients underwent 150 unplanned postoperative cardiac catheterizations. Median day of catheterization was postoperative day 20 (range 1-269 days). Survival 30 days postcatheterization was 85%; overall survival to hospital discharge was 72%. Indications for catheterization: 63 for hemodynamic evaluation, 46 for likely intervention, and 41 for assessment of surgical repair. Of the 150 hemodynamic/interventional catheterizations, 103 (69%) were associated with a change in clinical management: 59 trans-catheter interventions, 22 re-operations, 11 changes in medication, six changes in surgical plan, and five withdrawals of support. Complications included hemorrhage in two patients, supraventricular tachycardia in two patients, and transient complete heart block requiring cardiopulmonary resuscitation in one patient.
Conclusions:
Cardiac catheterization following congenital heart surgery may enable important diagnostic and therapeutic changes in clinical and surgical management. Complications were rare.
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