Medium-Term Outcomes in Pediatric Patients Undergoing Cardiac Catheterization Early After Congenital Cardiac Surgery.
Cardiac catheterization
Congenital cardiac surgery
Outcomes
Post-operative
Journal
Pediatric cardiology
ISSN: 1432-1971
Titre abrégé: Pediatr Cardiol
Pays: United States
ID NLM: 8003849
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
02
01
2023
accepted:
19
04
2023
medline:
26
9
2023
pubmed:
2
5
2023
entrez:
2
5
2023
Statut:
ppublish
Résumé
Safety and acute outcomes for patients who need catheterization shortly after congenital cardiac surgery has been established; literature on mid-term outcomes is lacking. We sought to evaluate the mid-term outcomes of patients who undergo early postoperative cardiac catheterization. This is a retrospective cohort study of patients who underwent cardiac catheterization within 6 weeks of congenital cardiac surgery with longitudinal follow-up and assessment of mid-term outcomes. Multivariable analysis was utilized to relate variables of interest to outcomes. 99 patients underwent cardiac catheterizations within 6 weeks of cardiac surgery between January 2008 and September 2016. Forty-six (45.5%) interventional procedures were performed at a median age of 41 days (IQR 21-192) and a median weight of 3.9 kg (3.3-6.6). During a median follow-up duration of 4.24 years (1.6-5.6) in study survivors, 61% of patients remained free from the primary endpoint (death and/or transplant). Sixty-nine patients (69.7%) underwent an unplanned surgical or catheter procedure. Renal failure at catheterization (OR 280.5, p 0.0199), inotropic medication at catheterization (OR 14.8, p 0.002), and younger age were all significantly associated with meeting the primary endpoint. Patients requiring surgical intervention as an initial additional intervention underwent more unplanned re-interventions, while patients who survived to hospital discharge demonstrated favorable mortality, though with frequent need for re-intervention. In patients requiring early postoperative cardiac catheterization, renal failure, younger age, and need for inotropic support at catheterization are significantly associated with meeting the primary endpoint.
Identifiants
pubmed: 37129601
doi: 10.1007/s00246-023-03171-4
pii: 10.1007/s00246-023-03171-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1808-1814Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Asoh K, Hickey E, Dorostkar PC, Chaturvedi R, van Arsdell G, Humpl T, Benson LN (2009) Outcomes of emergent cardiac catheterization following pediatric cardiac surgery. Catheter Cardiovasc Interv 73:933–940
doi: 10.1002/ccd.21919
pubmed: 19180662
Booth KL, Roth SJ, Perry SB, del Nido PJ, Wessel DL, Laussen PC (2002) Cardiac catheterization of patients supported by extracorporeal membrane oxygenation. J Am Coll Cardiol 40:1681–1686
doi: 10.1016/S0735-1097(02)02343-4
pubmed: 12427423
Zahn EM, Dobrolet NC, Nykanen DG, Ojito J, Hannan RL, Burke RP (2004) Interventional catheterization performed in the early postoperative period after congenital heart surgery in children. J Am Coll Cardiol 43:1264–1269
doi: 10.1016/j.jacc.2003.10.051
pubmed: 15063440
Nicholson GT, Kim DW, Vincent RN, Kogon BE, Miller BE, Petit CJ (2014) Cardiac catheterization in the early post-operative period after congenital cardiac surgery. JACC Cardiovasc Interv 7:1437–1443
doi: 10.1016/j.jcin.2014.06.022
pubmed: 25523535
Siehr SL, Martin MH, Axelrod D, Efron B, Peng L, Roth SJ, Perry S, Shin AY (2014) Outcomes following cardiac catheterization after congenital heart surgery. Catheter Cardiovasc Interv 84:622–628
doi: 10.1002/ccd.25490
pubmed: 24659225
Panda BR, Alphonso N, Govindasamy M, Anderson B, Stocker C, Karl TR (2014) Cardiac catheter procedures during extracorporeal life support: a risk-benefit analysis. World J Pediatr Congenit Heart Surg 5:31–37
doi: 10.1177/2150135113505297
pubmed: 24403352
Feltes TF, Bacha E, Beekman RH 3rd, Cheatham JP, Feinstein JA, Gomes AS, Hijazi ZM, Ing FF, de Moor M, Morrow WR, Mullins CE, Taubert KA, Zahn EM (2011) Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 123:2607–2652
doi: 10.1161/CIR.0b013e31821b1f10
pubmed: 21536996
Morgan CJ, Zappitelli M, Robertson CM, Alton GY, Sauve RS, Joffe AR, Ross DB, Rebeyka IM (2013) Risk factors for and outcomes of acute kidney injury in neonates undergoing complex cardiac surgery. J Pediatr 162:120-127.e121
doi: 10.1016/j.jpeds.2012.06.054
pubmed: 22878115
Blinder JJ, Goldstein SL, Lee VV, Baycroft A, Fraser CD, Nelson D, Jefferies JL (2012) Congenital heart surgery in infants: effects of acute kidney injury on outcomes. J Thorac Cardiovasc Surg 143:368–374
doi: 10.1016/j.jtcvs.2011.06.021
pubmed: 21798562
Yuan SM (2019) Acute kidney injury after pediatric cardiac surgery. Pediatr Neonatol 60:3–11
doi: 10.1016/j.pedneo.2018.03.007
pubmed: 29891225
Mehta R, Lee KJ, Chaturvedi R, Benson L (2008) Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 72:278–285
doi: 10.1002/ccd.21580
pubmed: 18546231
Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN (1998) Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32:1433–1440
doi: 10.1016/S0735-1097(98)00396-9
pubmed: 9809959
Booth P, Redington AN, Shinebourne EA, Rigby ML (1991) Early complications of interventional balloon catheterisation in infants and children. Br Heart J 65:109–112
doi: 10.1136/hrt.65.2.109
pubmed: 1867944
pmcid: 1024505
Aldoss O, Goldstein BH, Danon S, Goreczny S, Gray RG, Sathanandam S, Whiteside W, Williams DA, Zampi JD (2017) Acute and mid-term outcomes of stent implantation for recurrent coarctation of the aorta between the Norwood operation and Fontan completion: a multi-center Pediatric Interventional Cardiology Early Career Society Investigation. Catheter Cardiovasc Interv 90:972–979
doi: 10.1002/ccd.27231
pubmed: 28799708