Early Postoperative Congenital Cardiac Catheterization Outcomes: A Multicenter Study

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• Early postoperative catheterizations (EPOCs) are performed within 6 weeks of congenital heart surgery to manage residual lesions and gather clinical data.
• EPOCs are often perceived as carrying additional risks for vulnerable pediatric patients.

Purpose of the Study:

• To describe the characteristics of the EPOC population.
• To evaluate the safety of EPOC procedures.
• To compare outcomes of EPOC patients with matched non-EPOC patients and identify risk factors for adverse events.

Main Methods:

• A retrospective cohort study analyzed data from 13 institutions between January 2014 and December 2017.
• Included diagnostic and interventional catheterizations, excluding post-heart transplant cases.
• The primary outcome was a high-severity adverse event (AE); analyses compared EPOC patients with controls and evaluated risk factors.

Main Results:

• The study included 17,776 catheterizations, with 1,399 EPOCs.
• The high-severity AE rate was 8.9% in the EPOC cohort versus 8.4% in matched controls (P = .74), with no significant association between EPOC status and AEs in multivariable analysis (P = .17).
• EPOCs with AEs had longer procedure durations and a longer time from surgery to catheterization.

Conclusions:

• EPOCs are not associated with increased risk of high-severity adverse events.
• Individual patient factors, such as size and hemodynamic status, are important predictors of outcomes.
• Optimizing procedure timing and duration may improve outcomes and prevent clinical deterioration.