Outcomes and Risk Factors of Transcatheter Interventions to Create or Enlarge an Atrial Communication

Area of Science:

• Pediatric Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Atrial communication interventions are common but lack detailed adverse event data.
• Existing studies often combine different procedures and patient groups.

Purpose of the Study:

• To analyze adverse events in atrial communication interventions.
• Identify risk factors for clinically meaningful adverse events (CMAE).
• Differentiate risks based on patient age and procedural techniques.

Main Methods:

• Retrospective analysis of 432 cases from the C3PO-QI registry (2014-2017).
• Exclusion of cases with concurrent interventions.
• Analysis of patient demographics, procedure details, and CMAE.

Main Results:

• CMAE occurred in 6.5% of cases (2% mortality).
• Risk factors for CMAE included single ventricle and needle/RF atrial access.
• Neonates faced higher CMAE risks with ECMO, single-ventricle physiology, needle/RF access, and non-standard interventions.

Conclusions:

• Atrial communication interventions have age-dependent risks.
• Neonates are particularly vulnerable to CMAE from specific factors.
• Procedural technique and patient physiology significantly influence outcomes.