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Cardiac catheterization for hemoptysis in a Children's Hospital Cardiac Catheterization Laboratory: A 15 year
Takeshi Sasaki1, Thomas J Forbes2, Robert D Ross2
1Division of Cardiology, Children's Hospital of Michigan, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA; Department of Pediatric Cardiology, Osaka City General Hospital Pediatric Medical Center, Osaka, Japan.
Insights
Cardiac catheterization effectively diagnoses hemoptysis causes in pediatric patients, with transcatheter interventions showing significant efficacy. While recurrent bleeding occurs, this procedure offers a valuable treatment for hemoptysis, particularly in congenital heart disease cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Hemoptysis, or coughing up blood, can stem from various underlying conditions.
- Cardiac catheterization offers a diagnostic pathway for identifying the sources of hemoptysis.
- Transcatheter interventions present a minimally invasive treatment option for hemoptysis.
Purpose of the Study:
- To assess the diagnostic accuracy of cardiac catheterization in patients with hemoptysis.
- To evaluate the effectiveness of transcatheter interventions for treating hemoptysis.
- To analyze outcomes in a pediatric cohort undergoing these procedures for hemoptysis.
Main Methods:
- A retrospective analysis of pediatric patients undergoing cardiac catheterization for hemoptysis between 2006 and 2020.
- Review of diagnostic utility and intervention success rates.
- Assessment of patient outcomes, including recurrence and mortality.
Main Results:
- Cardiac catheterization demonstrated 81% diagnostic utility for hemoptysis.
- Transcatheter interventions were performed in 67% of patients, with a 79% effectiveness rate.
- Recurrent hemoptysis occurred in 50% of cases post-intervention, and overall mortality was 19%.
Conclusions:
- Cardiac catheterization is a valuable diagnostic tool for hemoptysis, especially in pediatric congenital heart disease.
- Transcatheter interventions are effective for hemoptysis treatment, despite challenges like recurrence and mortality.
- The study highlights the role of interventional cardiology in managing complex hemoptysis cases.
Objectives:
The aim of this study was to evaluate the diagnostic utility of cardiac catheterization and the efficacy of transcatheter intervention in patients with hemoptysis.
Background:
Cardiac catheterization may play a role in identifying the etiologies of hemoptysis with the potential for transcatheter intervention.
Methods:
This was a retrospective study of all the patients who were brought to the pediatric cardiac catheterization laboratory for the indication of hemoptysis over a 15-year period (2006-2020).
Results:
Twenty-one patients underwent 28 cardiac catheterizations. The median age was 17.4 years (range 0.3-60.0 years), and the underlying cardiac diagnoses were normal heart n = 3, pulmonary hypertension 1, heart transplant 1, pulmonary arteriovenous malformation 1, pulmonary vein disease 3, biventricular congenital heart diseases 5, and single ventricles 7. The diagnostic utility of catheterization was 81% (17/21). At two-thirds (18/28) of catheterizations, transcatheter interventions were performed in 14/21 (67%) patients: aortopulmonary collateral embolization 14, aortopulmonary and veno-venous collateral embolization 1, and pulmonary arteriovenous malformation embolization 3. Although recurrent hemoptysis was frequent (50%) post-intervention, the final effectiveness of transcatheter interventions was 79% (11/14 patients). Overall mortality was 19% (4/21), all in those presenting with massive hemoptysis.
Conclusions:
Cardiac catheterization was shown to have good diagnostic utility for hemoptysis especially in patients with underlying congenital heart disease. Despite the high mortality and recurrent hemoptysis rate, transcatheter interventions were effective in our cohort.
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