Related Experiment Video
Updated: Oct 8, 2025
Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
Adverse Events Associated with Cardiac Catheterization in Children Supported with Ventricular Assist Devices
Alyssa Power1, Manchula Navaratnam2, Jenna M Murray3
1From the Department of Pediatrics, UT Southwestern Medical Center and Children's Medical Center, Dallas, Texas, USA.
Insights
Cardiac catheterization is safe for children on ventricular assist device (VAD) support, even those with complex heart conditions. This study found an acceptable adverse event profile, supporting its use in critically ill pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Medical Device Technology
Background:
- Children on ventricular assist device (VAD) support present unique challenges due to small size, congenital heart disease (CHD), and potential need for biventricular VAD (BiVAD) support.
- Cardiac catheterization is an invasive diagnostic procedure with inherent risks, particularly in critically ill pediatric patients.
Purpose of the Study:
- To evaluate the safety and adverse event profile of cardiac catheterization in pediatric patients supported by VADs.
- To identify factors associated with adverse events in this high-risk population.
Main Methods:
- Retrospective review of pediatric patients on VAD support who underwent cardiac catheterization between January 1, 2014, and September 1, 2019.
- Adverse events (AEs) were identified using definitions adapted from Pedimacs and categorized as related or unrelated to the procedure.
- Sixty procedures were performed on 39 patients with various underlying diagnoses and VAD types, many in intensive care unit (ICU) settings.
Main Results:
- Nine adverse events possibly related to catheterization occurred, including respiratory failure (6), major bleeding (2), and procedural arrhythmia (1).
- AE occurrence was significantly associated with intensive care unit (ICU) status (P=0.01), biventricular VAD (BiVAD) support (P=0.04), and catheterization for worsening clinical status (P=0.04).
- Despite high medical acuity, the overall adverse event profile was deemed acceptable.
Conclusions:
- Cardiac catheterization can be performed safely in pediatric patients on VAD support, even those with complex congenital heart disease and biventricular support.
- The procedure demonstrates an acceptable adverse event profile in this vulnerable population, supporting its continued use for diagnostic evaluation.
- Patient acuity, BiVAD support, and indication for worsening status are key factors influencing adverse event risk.
Abstract:
Children on ventricular assist device (VAD) support can present several unique challenges, including small patient size, univentricular or biventricular congenital heart disease (1V- or 2V-CHD) and need for biventricular VAD (BiVAD) support. While cardiac catheterization can provide valuable information, it is an invasive procedure with inherent risks. We sought to evaluate the safety of catheterization in pediatric patients on VAD support. We performed a retrospective review of patients on VAD support who underwent catheterization at Lucile Packard Children's Hospital between January 1, 2014 and September 1, 2019. Using definitions adapted from Pedimacs, adverse events (AEs) after catheterization were identified, including arrhythmia; major bleeding or acute kidney injury within 24 hours; respiratory failure persisting at 24 hours; and stroke, pericardial effusion, device malfunction, bacteremia or death within 7 days. AEs were categorized as related or unrelated to catheterization. Sixty procedures were performed on 39 patients. Underlying diagnoses were dilated cardiomyopathy (48%), 1V-CHD (35%), 2V-CHD (8%), and other (8%). Devices were implantable continuous flow (72%), paracorporeal pulsatile (18%) and paracorporeal continuous flow (10%). Catheterizations were performed on patients in the ICU (60%), on inotropic support (42%), with deteriorating clinical status (37%) and on BiVAD support (12%). There were 9 AEs possibly related to catheterization including 6 episodes of respiratory failure, 2 major bleeding events, and 1 procedural arrhythmia. AE occurrence was associated with ICU status ( P = 0.01), BiVAD support ( P = 0.04) and procedural indication to evaluate worsening clinical status ( P = 0.04). Despite high medical acuity, catheterization can be performed with an acceptable AE profile in children on VAD support.
More Related Videos
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:21Cardiac Catheterization II: Right Heart Catheterization
01:26Cardiac Catheterization IV: Nursing Management
01:24Cardiac Catheterization III: Left Heart Catheterization
01:29Cardiomyopathy V: Interprofessional Care
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management