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The results of interventional catheterization in infants weighing under 2,000 g
Birgül Varan1, N Kürşad Tokel1, Kahraman Yakut1
1Department of Pediatric Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey.
Insights
Interventional cardiac catheterization offers life-saving treatment for infants under 2,000 grams, despite significant complications. This study evaluates outcomes and complications in this high-risk pediatric group.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Neonatal Medicine
Background:
- Infants weighing less than 2,000 grams present unique challenges for cardiac interventions.
- Evaluating the safety and efficacy of interventional cardiac catheterization in this low birth weight population is crucial.
Purpose of the Study:
- To assess the early and mid-term results of interventional cardiac catheterization in infants weighing less than 2,000 grams.
- To identify and analyze procedure-related complications in this vulnerable patient group.
Main Methods:
- Retrospective analysis of 22 infants (<2,000 g) undergoing 23 interventional cardiac catheterizations between May 1998 and April 2017.
- Procedures included balloon angioplasty (coarctation, aortic/pulmonary valves), septostomy, PDA closure, and stent placement.
Main Results:
- An overall procedural success rate of 95.6% was achieved.
- The rate of serious complications was 18%, with low hemoglobin and vascular injury being most frequent.
- Mean follow-up was 3.2 years; 2 patients needed reintervention, and 3 required surgery.
Conclusions:
- Interventional cardiac catheterization can be life-saving for premature infants (<2,000 g) with congenital heart defects.
- While effective, the procedure is associated with significant complications in low birth weight newborns.
- Compared to surgery, interventional catheterization may offer a less invasive approach for this high-risk group.
Background:
The aim of this study was to evaluate the early and mid-term results of interventional cardiac catheterization and procedure-related complications in infants weighing <2,000 g.
Methods:
Between May 1998 and April 2017, 22 patients (14 males, 8 females; mean age 14±8.4 days; range, 1 to 30 days) weighing <2,000 g who underwent a total of 23 interventional cardiac catheterization were retrospectively analyzed. Procedures were balloon coarctation angioplasty in 14, balloon atrial septostomy in five, balloon aortic valvuloplasty in one, balloon pulmonary valvuloplasty in one, patent ductus arteriosus closure in one, and stent placement in the ductus in one patient. Another patient underwent balloon coarctation angioplasty and balloon aortic valvuloplasty in the same session.
Results:
The overall success rate of the interventional procedures was 95.6%. The mean follow-up was 3.2±1.6 years (range, 1 to 5.5) for 18 patients with available records. The rate of serious complications was 18%. The most frequent complications in the early period were low hemoglobin levels requiring erythrocyte suspension transfusion (54.5%) and vascular injury (54.5%). Two patients required reintervention, one patient required surgery after the second intervention, and three patients required only surgery. Six patients underwent palliative interventional procedures, and interventional procedures led to definitive treatment in five patients.
Conclusion:
The mortality and morbidity rate of surgery is high in premature under 2,000 g infants and interventional heart catheterization can be life-saving in this patient group, although it is associated with significant complications in low birth weight newborns.
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