Cardiac Catheterization in the Early Post-Operative Period After Congenital Cardiac Surgery

• Published in: JACC. Cardiovascular interventions 2014-12, Vol.7 (12), p.1437-1443
• Main Authors: Nicholson, George T., MD, Kim, Dennis W., MD, PhD, Vincent, Robert N., MD, Kogon, Brian E., MD, Miller, Bruce E., MD, Petit, Christopher J., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - mortality; Balloon Occlusion - adverse effects; Balloon Occlusion - mortality; cardiac catheterization; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Cardiac Catheterization - mortality; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiovascular; Child; Child, Preschool; congenital cardiac surgery; congenital heart disease; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Humans; Infant; Postoperative Care; Postoperative Complications - diagnosis; Postoperative Complications - mortality; Postoperative Complications - therapy; Predictive Value of Tests; Retrospective Studies; Stents; Time Factors; Treatment Outcome
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2014.06.022

Abstract Objectives This study sought to demonstrate that early cardiac catheterization, whether used solely as a diagnostic modality or for the use of transcatheter interventional techniques, can be used effectively and with an acceptable risk in the post-operative period. Background Cardiac catheterization offers important treatment for patients with congenital heart disease. Early post-operative cardiac catheterization is often necessary to diagnose and treat residual anatomic defects. Experience with interventional catheterization to address post-operative concerns is limited. Methods This was a retrospective cohort study. The medical and catheterization data of pediatric patients who underwent a cardiac catheterization ≤30 days after congenital heart surgery between November 2004 and July 2013 were reviewed. Patients who underwent right heart catheterization and endomyocardial biopsy after heart transplantation were excluded. Results A total of 219 catheterizations (91 interventional procedures, 128 noninterventional catheterizations) were performed on 193 patients. Sixty-five interventions (71.43%) were dilations, either balloon angioplasty or stent implantation. There was no difference in survival to hospital discharge between those who underwent an interventional versus noninterventional catheterization (p = 0.93). One-year post-operative survival was comparable between those who underwent an intervention (66%) versus diagnostic (71%) catheterization (p = 0.58). There was no difference in the incidence of major or minor complications between the interventional and diagnostic catheterization cohorts (p = 0.21). Conclusions Cardiac catheterization, including transcatheter interventions, can be performed safely in the immediate post-operative period after congenital heart surgery.