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Early Cardiac Catheterizations within 30 Days Post Congenital Heart Surgery in Children
Authors:Daniel Quandt  Alessia Callegari  Oliver Niesse  Martin Christmann  Anke Meinhold  Hitendu Dave  Walter Knirsch  Oliver Kretschmar
Abstract:Background: This study set out to assess the indications, feasibility, safety, and outcome of early cardiac catheterizations (CC) within 30 days after congenital heart surgery (CHS) in children. Methods and Results: This is aretrospective, single-center case review study of all CC within 30 days after CHS between 1/2010-12/2020. A totalof 317 (138 diagnostic, 179 interventional) CC were performed in 245 patients at a median of 4 days (IQR 13)after CHS. The median age was 3 months (IQR 6), and body weight was 5 kg (IQR 4). A total of 194 (61.2%) CCwere performed in patients with univentricular hearts. CC revealed significant pathologies leading to earlyredo-surgery in 37 patients (12%). The transcatheter interventions primarily were needed in patients aftercavo-pulmonary connection (n = 69%, 21.8%), right ventricle to pulmonary artery conduit (n = 39%, 12.3%),and Norwood-I surgery (n = 34%, 10.7%) presenting with hypoxemia, prolonged postoperative course, andsuspected arterial stenosis on echocardiography. The clinical impact of an early postoperative transcatheter intervention for the following clinical course was high in most cases. There were nine (2.8%) major and 20 (6.3%)minor intra-procedural complications. Risk factor analysis revealed no difference for the occurrence of complications for patients’ age, weight, and time from initial CHS, underlying uni- vs. biventricular heart disease, orECMO. Conclusion: Early CC within 30 days after CHS in children can be performed safely with a high diagnostic and therapeutic value. The rate of complications is low, while the therapeutic consequence is relevant.
Keywords:Early postoperative cardiac catheterization  congenital heart surgery  children
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