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Complications associated with pediatric cardiac catheterization

R Vitiello1, B W McCrindle, D Nykanen

  • 1Department of Pediatrics, The University of Toronto School of Medicine, The Hospital for Sick Children, Ontario, Canada.

Journal of the American College of Cardiology
|November 11, 1998
PubMed
Summary

Pediatric cardiac catheterizations carry risks, with 8.8% of procedures causing complications. Young age and interventional procedures increase the risk of adverse events and mortality in children.

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Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • The pediatric catheterization laboratory has expanded its role beyond diagnosis to include therapeutic interventions.
  • Despite advancements, cardiac catheterization remains crucial for diagnosing congenital heart defects and hemodynamic abnormalities.

Purpose of the Study:

  • To assess the relative risks associated with pediatric diagnostic, interventional, and electrophysiologic catheterizations.
  • To identify independent risk factors contributing to complications in pediatric cardiac catheterization procedures.

Main Methods:

  • A retrospective analysis of 4,952 consecutive pediatric catheterization procedures.
  • Classification of complications into major and minor categories, with specific attention to vascular and arrhythmic events.

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Main Results:

  • Overall complication rate was 8.8% (436/4952), with vascular complications (3.8%) being most frequent.
  • Major complications occurred in 102 cases, with arrhythmias being the most common (24 cases).
  • Mortality directly related to the procedure was 0.14% (7/4952), predominantly in infants; young patient age and interventional procedures were identified as independent risk factors.

Conclusions:

  • Pediatric cardiac catheterization is associated with ongoing risks, necessitating improvements in equipment and vascular access techniques.
  • Young patient age and the performance of interventional procedures are significant risk factors for morbidity and mortality.
  • Future research should focus on developing more flexible and smaller equipment and exploring alternative vascular access methods to mitigate risks.