Catheterization Performed in the Early Postoperative Period After Congenital Heart Surgery in Children

• Published in: Pediatric cardiology Vol. 40; no. 4; pp. 827 - 833
• Main Authors: Eraso-Díaz del Castillo, Ana María, Escobar-Díaz, María Clara, Lince Varela, Rafael, Díaz Medina, Luis Horacio, Cañas Arenas, Eliana Mabel
• Format: Journal Article
• Language: English
• Published: New York Springer US 15.04.2019; Springer
• Subjects: Cardiac Catheterization - adverse effects; Cardiac Catheterization - statistics & numerical data; Cardiac Surgery; Cardiac Surgical Procedures - adverse effects; Cardiology; Catheterization; Children; Children's furniture; Complications and side effects; Congenital heart disease; Female; Genetic disorders; Health aspects; Heart; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Humans; Infant; Infant, Newborn; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original Article; Pediatrics; Postoperative Complications - epidemiology; Postoperative Period; Retrospective Studies; Treatment Outcome; Vascular Surgery; Cardiac catheterization; Thoracic surgery; Child; Heart defects, congenital
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-019-02078-3

The aim of this study was to describe pediatric patients who underwent early postoperative cardiac catheterization after congenital heart surgery, their clinical indications, findings, interventions, and complications in a cardiovascular center. A descriptive retrospective study was performed. All catheterizations performed within 6 weeks after congenital heart surgery between January 2004 and December 2014 were reviewed. We analyzed 101 early postoperative catheterizations. They were performed on median postoperative day five (IQR: 0–39); the median age was 64 days (IQR: 22–240). The most common diagnoses were single ventricle (53%), left heart obstruction (12%), and tetralogy of fallot or pulmonary atresia with ventricular septal defect (11%). Most common indications were persistent cyanosis (53%), low cardiac output (24%), and residual defect on echocardiogram (20%). Most frequent findings during the catheterization were pulmonary artery stenosis (29%), surgical conduit obstruction (12%), and coarctation or hypoplasia of the aorta (11%). Forty-six (45%) procedures involved intervention. Most frequent interventions were pulmonary artery, aorta, and Blalock–Taussig fistula angioplasty with or without stent implantation. There were adverse effects in 11 cases (11%), and 30-day mortality was 28% (28 patients) with the majority unrelated to the catheterization directly. Although early postoperative catheterizations are high-risk procedures, they are currently a very good option to solve acute problems in critically ill patients. This study provides relevant information for a better understanding and approach to this complex group of patients.