Related Experiment Videos
[Heart catheterization in newborn and young infants. Description of the method]
Insights
Heart catheterization frequency increased with surgical advances but decreased with echocardiography. Echocardiography significantly reduced the risk for infants undergoing cardiac procedures.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Context:
- Review of 343 newborns and infants undergoing heart catheterization from 1968-1982.
- Examined trends in catheterization frequency, diagnoses, and lethality.
- Noted impact of Rashkind procedure and advancements in cardiac surgery.
Purpose:
- Investigate variations in heart catheterization frequency and diagnoses over time.
- Analyze changes in lethality rates across different diagnostic groups.
- Assess the influence of echocardiography on diagnostic practices and outcomes.
Summary:
- Heart catheterization frequency rose with the Rashkind procedure and surgical improvements, later plateauing.
- Echocardiography led to decreased catheterizations for conditions like HLH and PFC.
- New challenges, such as in premature infants, still necessitate catheterization.
Impact:
- Identified significantly higher lethality (27%) in patients catheterized to rule out Transposition of the Great Arteries (TGA) compared to those with TGA (3.7%).
- Echocardiography introduction substantially reduced the risk associated with heart catheterization.
- Highlights the evolving role of diagnostic tools in pediatric cardiac care.
Abstract:
The data of 343 newborns and young infants were reviewed who, from 1968 until August 1982, had undergone heart catheterization. Variations in frequency of catheterization and diagnoses as well as lethality were investigated. The first rise of heart catheterization performances could be noted in the years of 1968 and 1969 (by routine application of the Rashkind procedure), another remarkable rise took place in the years from 1971 to 1975, probably due to better feasibilities of modern cardiac surgery. Later on, a new dynamic plateau was developed. With the utilization of echocardiography, a significant decrease of heart catheterization performances in certain diagnostic groups (HLH, PFC) was registered. Nowadays, however, new diagnostic challenges (infants with low gestational age, respiratory problems, PDA) require heart catheterization. Comparison of the different diagnostic groups' lethality rate reveals that children undergoing heart catheterization, in order to rule out TGA, demonstrate a remarkably higher lethality rate (27%) than children suffering from TGA (3.7%). Introduction of echocardiography has decreased this risk significantly.