Complications associated with pediatric cardiac catheterization
The role of the pediatric catheterization laboratory has evolved in the last two decades as a therapeutic modality although remaining an important tool for anatomic and especially hemodynamic diagnosis.
Methods: The study of 4578 consecutive pediatric catheterization procedures was undertaken from January 1995 to December 2008. Patientís age 4.2+/- 5.12 years (1 days- 20 years), weight 14.8+/-13.5 (1.1- 85) kg. Of the 10.3 percent patients are under 1 month. There were 3232 diagnostic, 1346 (%29.4) interventional procedure including 34 patients with two intevertional procedures. The access and procedure time was 6.8 +/- 8.7 (0.5-65 minutes) and 45.5+/- 21.4 (20-210) minutes respectively.
One or more complications occurred in 512 studies (%11.2) and were classified as major in 132 (2.88%) and minor in 591 (12.9 %). The frequent major complications were transient arterial thrombosis 0.6/1000, serious arrhythmias 0.5/1000, cardiac arrest or serious hypotension 5/1000. Death occurred in three
cases (0.06 %) as a direct complication of the procedure. The most common minor complication was decreased or absent arterial pulse (9.2 %). Other minor complications were tolerated transient arrhythmic episodes (1.59 %), spell (0.24 %), bleeding or hematom at catheterization site (1.42%). Indepented risk factors for complication were age, weight, qualification of pediatric cardiology and undergoing an interventional procedure.
Conclusion: Complication rate of diagnostic and interventional cardiac catheterization are low but neither negligible nor irreducible. Patient age and interventional studies are risk factors for morbidity and mortality. There is a clear need to establish a prospective recording system.