Complications of cardiac catheterization in children with congenital heart disease

Özet

Catheterization procedures for congenital heart disease include a broad rangeof procedures with a large spectrum of potential adverse outcomes. Weaimed to determine the incidence of various complications during pediatriccardiac catheterizations and to designate the relative risk factors for suchcomplications.All pediatric patients undergoing cardiac catheterizations between January2005-December 2010 were included. Data are collected prospectively by fillingout computerized catheterization reports. Patient records were scanned forpotential risk factors retrospectively. Groups were divided based on cardiacdiagnosis; type of procedure. Adverse events were categorized into major orminor events. A total of 2662 cardiac catheterizations were performed duringthis period. The mean age of patients was 53.2±64.3 months. Diagnosticcatheterizations were done for 1797 (67.5%) patients, and interventionalprocedures were done in 865 (32.5%) cases. Adverse events were observedin 688 patients (26%) during 941 procedures. Minor and major events wereseen in 21.4% and 7.1% of the procedures respectively. Most frequent majorcomplications were anesthesia related (6%), most frequent minor complicationswere vascular complications (45.2%). Complications were more frequent inyounger patients (p=0.0001), during interventional procedures (p=0.0001).Thirteen patients died after a cardiac catheterization; they were youngerand had longer procedures compared to those who survived (p=0.0001).Vascular complications were frequent among younger patients, with prolongedprocedure time and vessel access (p<0.0001). Cyanotic patients had morecomplications (p<0.05; OR for major and minor complications: 3.5 and 2respectively). Minor complications were 2.7 times more likely in ventricularoutflow obstructions (p<0.05).The complication rates of cardiac catheterization in children are low, but notnegligible. Defining risk factors will help anticipate adverse events, whichwill guide in preparation for rescue procedures and improvement of patientsafety systems in catheterization laboratories.