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Published on: July 18, 2014
Cardiac Catheterization in the Early Post-Operative Period after Congenital Heart Surgery
Taner Kasar1, Ibrahim Cansaran Tanidir1, Erkut Ozturk1,2
1Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital.
Insights
Early cardiac catheterization in pediatric congenital heart disease patients is safe and effective, even with extracorporeal membrane oxygenation (ECMO) support. This procedure aids in diagnosing and treating post-operative complications without increasing mortality.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Increasing number of diagnostic and interventional cardiac catheterizations in the post-operative period of congenital heart diseases (CHD).
- Need to evaluate the safety and efficacy of early post-operative cardiac catheterization after congenital heart surgery (CHS).
Purpose of the Study:
- To evaluate data of patients who underwent cardiac catheterization in the early post-operative period after congenital heart surgery (CHS).
- Assess the outcomes and complications of early post-operative cardiac catheterization in pediatric CHD patients.
Main Methods:
- Retrospective evaluation of patients who underwent cardiac catheterization within 30 days after CHS.
- Analysis of patient demographics, surgical history, catheterization details, and outcomes.
Main Results:
- 50 (1.9%) patients underwent early post-operative cardiac catheterization. 58% were males, median age 7.5 months, median weight 6 kg.
- Procedures included diagnostic (48%) and interventional (52%). 30% required reoperation. Major complications occurred in 8% with no procedural mortality.
- 16 patients underwent catheterization under extracorporeal membrane oxygenation (ECMO) support.
Conclusions:
- Early cardiac catheterization is a valuable tool for diagnosing and treating post-operative complications in pediatric CHD patients.
- The procedure is safe, even when performed under ECMO support, with a low rate of major complications and no procedural mortality.
- Cardiac catheterization should be considered without hesitation for patients with unclear hemodynamic or clinical issues post-operatively.
Background:
The number of diagnostic and interventional cardiac catheterization procedures are increasing in the post-operative period of congenital heart diseases (CHD). The aim of this study was to evaluate data of patients who underwent cardiac catheterization in the early post-operative period after congenital heart surgery (CHS).
Methods:
We retrospectively evaluated the data of patients who underwent cardiac catheterization within 30 days after CHS.
Results:
Between 2010 and 2016 in our hospital, 2584 children had operations, and 2911 children underwent cardiac catheterization due to CHD. Cardiac catheterization was performed in 50 (1.9% of the surgeries) of these patients during the early post-operative period. Twenty-nine (58%) of the patients were males. The median age was 7.5 months (range: 15 days-12.5 years), and the median body weight was 6 kg (range: 3-35 kg). Twenty-eight (56%) of the patients had two-ventricle, and 22 (44%) had single ventricle physiology. The median RACHS-1 score was 3 (range: 1-6). Cardiac catheterization was performed under extracorporeal membrane oxygenation (ECMO) support in 16 of the patients. Twenty-four (48%) patients underwent diagnostic catheterization, while 26 (52%) had interventional procedures. Fifteen (30%) patients had a reoperation due to anatomic problems identified during catheterization. Major complications developed in 4 (8%) patients. There was no cases of procedural mortality due to catheterization.
Conclusions:
Cardiac catheterization should be performed in post-operative cardiac patients without hesitation, even under ECMO, if significant hemodynamic or clinical problems cannot be identified clearly by other non- interventional diagnostic techniques.
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