Evaluating Racial Disparities in Access to Common Pediatric/Congenital Transcatheter Interventions.

Area of Science:

• Pediatric Cardiology
• Interventional Cardiology
• Health Disparities Research

Background:

• Congenital heart surgery outcomes show observed disparities.
• Such disparities have not been previously studied in pediatric/congenital interventional cardiology.
• This study addresses this gap by examining race-ethnicity in interventional cardiology.

Purpose of the Study:

• To determine if Black race or Hispanic ethnicity is associated with disparities in diagnosis.
• To investigate disparities in referral patterns for interventional cardiology procedures.
• To assess disparities in access to cardiac catheterization for pediatric patients.

Main Methods:

• Multicenter cohort study of pediatric patients (≤18 years) undergoing device closure of atrial septal defect (ASD), patent ductus arteriosus, balloon pulmonary valvuloplasty (BPV), or balloon aortic valvuloplasty (BAV).
• Data collected from the IMPACT registry between June 1, 2016, and December 31, 2022.
• Evaluated associations between race-ethnicity, age at procedure, disease severity, risk of adverse events, and treatment center volume.

Main Results:

• 20,632 subjects were analyzed across ASD, patent ductus arteriosus, BPV, and BAV procedures.
• Race-ethnicity was linked to older age at procedure for ASD and BPV (P < 0.05).
• Minority race-ethnicity correlated with more severe disease for BPV and BAV (P < 0.05) and higher proportions treated at low-volume centers.

Conclusions:

• Minority race-ethnicity is associated with delayed referral and more severe congenital heart disease.
• These findings suggest significant disparities in referral and/or access to care.
• Future efforts should prioritize screening, diagnosis, and equitable access to mitigate these disparities.