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Published on: September 11, 2018
Transcatheter Retrieval of Cardiovascular Foreign Bodies in Children: A 15-Year Single Centre Experience
Vikram Kudumula1, Oliver Stumper2, Patrick Noonan3
1East Midlands Congenital Heart Centre, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Insights
Transcatheter retrieval of cardiovascular foreign bodies in children is a safe and effective procedure, with a 90% success rate. This minimally invasive approach often avoids the need for open-heart surgery in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Interventional catheter treatments for congenital heart disease are increasing.
- Effective retrieval of embolized cardiac devices and foreign bodies is crucial.
- Limited large-scale studies exist on pediatric transcatheter foreign body retrieval.
Purpose of the Study:
- To evaluate the safety and efficacy of transcatheter foreign body retrieval in children.
- To assess the outcomes of cardiovascular foreign body retrieval in a pediatric population over a 15-year period.
Main Methods:
- Retrospective review of 78 pediatric patients undergoing transcatheter foreign body retrieval.
- Data collected from January 1997 to September 2012 at a tertiary cardiac center.
- Analysis of retrieval success rates, devices used, procedure times, and complications.
Main Results:
- Successful transcatheter retrieval in 70 out of 78 patients (90%).
- Surgical retrieval was necessary in 6 patients; 2 patients had small embolized coils left in situ.
- Gooseneck snare was the most frequently used retrieval device; no procedural deaths occurred.
Conclusions:
- Transcatheter retrieval of cardiovascular foreign bodies is a safe and effective option for most children.
- This technique can successfully obviate the need for surgical intervention.
- Maintaining a comprehensive inventory of retrieval equipment and trained staff is essential.
Abstract:
There has been a rapid increase in the practice of interventional catheter treatment of congenital heart disease. Catheter retrieval of embolized cardiac devices and other foreign bodies is essential, yet no large studies have been reported in the paediatric population. Retrospective 15-year review of all children who underwent transcatheter foreign body retrieval in a tertiary cardiac centre from January 1997 to September 2012. Transcatheter retrieval of foreign bodies from the cardiovascular system was attempted in 78 patients [median age 4 (0.02-16) years and median weight 15 (1.7-74) kg] including 46 embolized devices. Transcatheter retrieval was successful in 70/78 (90%), surgical retrieval was required in 6. In two patients, small embolized coils were left in situ. Gooseneck snare was the most commonly used retrieval device. Median procedure and screening times were 90 (15-316) and 31 (2-161) min, respectively. There were no procedural deaths. Transient loss of foot pulses occurred in 5 and 2 patients required blood transfusion. Transcatheter retrieval of cardiovascular foreign bodies can be performed safely in the majority of children thus obviating the need for surgery. It is essential to have a comprehensive inventory of retrieval equipment and interventional staff conversant with its use.
