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Cardiac catheterization in the early post-operative period after congenital cardiac surgery
George T Nicholson1, Dennis W Kim1, Robert N Vincent1
1Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta/Emory University School of Medicine, Atlanta, Georgia.
Insights
Early cardiac catheterization, including interventional procedures, is safe and effective in the post-operative period for congenital heart disease patients. This diagnostic and therapeutic approach shows comparable survival and complication rates to non-interventional methods.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Cardiac catheterization is crucial for treating congenital heart disease.
- Early post-operative catheterization is vital for diagnosing and managing residual defects.
- Limited data exists on the efficacy of interventional catheterization post-surgery.
Purpose of the Study:
- To demonstrate the effectiveness and safety of early cardiac catheterization post-congenital heart surgery.
- To evaluate both diagnostic and interventional catheterization procedures in the post-operative setting.
Main Methods:
- Retrospective cohort study of pediatric patients undergoing cardiac catheterization within 30 days of congenital heart surgery.
- Data reviewed from November 2004 to July 2013.
- Exclusion of patients undergoing right heart catheterization and endomyocardial biopsy post-heart transplantation.
Main Results:
- 219 catheterizations (91 interventional, 128 non-interventional) performed on 193 patients.
- Interventions primarily included balloon angioplasty or stent implantation (65 cases).
- No significant differences in survival or complication rates between interventional and non-interventional groups.
Conclusions:
- Cardiac catheterization, including transcatheter interventions, is safe in the immediate post-operative period after congenital heart surgery.
- Early post-operative catheterization is an effective tool for managing congenital heart disease.
Objectives:
This study sought to demonstrate that early cardiac catheterization, whether used solely as a diagnostic modality or for the use of transcatheter interventional techniques, can be used effectively and with an acceptable risk in the post-operative period.
Background:
Cardiac catheterization offers important treatment for patients with congenital heart disease. Early post-operative cardiac catheterization is often necessary to diagnose and treat residual anatomic defects. Experience with interventional catheterization to address post-operative concerns is limited.
Methods:
This was a retrospective cohort study. The medical and catheterization data of pediatric patients who underwent a cardiac catheterization ≤30 days after congenital heart surgery between November 2004 and July 2013 were reviewed. Patients who underwent right heart catheterization and endomyocardial biopsy after heart transplantation were excluded.
Results:
A total of 219 catheterizations (91 interventional procedures, 128 noninterventional catheterizations) were performed on 193 patients. Sixty-five interventions (71.43%) were dilations, either balloon angioplasty or stent implantation. There was no difference in survival to hospital discharge between those who underwent an interventional versus noninterventional catheterization (p = 0.93). One-year post-operative survival was comparable between those who underwent an intervention (66%) versus diagnostic (71%) catheterization (p = 0.58). There was no difference in the incidence of major or minor complications between the interventional and diagnostic catheterization cohorts (p = 0.21).
Conclusions:
Cardiac catheterization, including transcatheter interventions, can be performed safely in the immediate post-operative period after congenital heart surgery.
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