Indications and outcomes of cardiac catheterization following congenital heart surgery in children

Abstract Background Cardiac catheterization after congenital heart surgery may play an important role in the diagnosis and management of patients with a complicated or unusual post-operative course. The main objective of this study was to evaluate the safety, efficacy, and outcome of cardiac catheterization performed in the early post-operative period following congenital heart surgery. All patients who underwent cardiac catheterization after congenital heart surgery during the same admission of cardiac surgery from November 2015 to May 2018 were included in the study. Results Thirty procedures were performed for 27 patients (20 interventional and 10 diagnostic). The median age of the patients was 15 months (15 days to 20 years), median weight was 8.2 kg (3.4 to 53 kg), and median time from surgery was 3 days (0–32 days). Eleven procedures were performed for 11 patients on extracorporeal membrane oxygenation (ECMO) support. The main indications for catheterization included the inability to wean from ECMO (10 procedures) and cyanosis (10 procedures). Interventional procedures included angioplasty using stents (10 procedures, success rate of 90%), angioplasty using only balloons (2 procedures, success rate of 50%), and occlusion for residual shunts (8 procedures, success rate of 100%). No mortality was recorded during any procedure. Vasoactive–inotropic score had significantly decreased 48 h after catheterization when compared to pre-catheterization scores (p = 0.0001). Moreover, 72% of patients connected to ECMO support were successfully weaned from ECMO after catheterization. Procedural complications were recorded in 3 interventional procedures. Survival to hospital discharge was 55.5% and overall survival was 52%. Patients on ECMO support had a higher mortality than other patients. Conclusion Cardiac catheterization can be performed safely in the early post-operative period, and it could improve the outcome of the patient (depending on the complexity of the cardiac lesions involved).

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EARLY CARDIAC CATHETERIZATION FOLLOWING CONGENITAL HEART SURGERY IS NOT ASSOCIATED WITH INCREASED RISK FOR SERIOUS ADVERSE EVENTS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)60438-x ◽

2010 ◽

Vol 55 (10) ◽

pp. A45.E437 ◽

Cited By ~ 1

Author(s):

Joshua W. Salvin ◽

Lisa Bergersen ◽

Peter C. Laussen ◽

Sarah A. Teele ◽

Audrey C. Marshall ◽

...

Keyword(s):

Adverse Events ◽

Cardiac Catheterization ◽

Congenital Heart ◽

Heart Surgery ◽

Congenital Heart Surgery ◽

Serious Adverse Events ◽

Increased Risk

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Impact of Cardiac Catheterization on the Outcome of Extracorporeal Membrane Oxygenation (ECMO) After Congenital Cardiac Surgery - Two Centers Experience

10.21203/rs.3.rs-167694/v1 ◽

2021 ◽

Author(s):

Gaser Abdelmohsen ◽

Jameel Al-Ata ◽

Naif Alkhushi ◽

Saud Bahaidarah ◽

Hysam Baho ◽

...

Keyword(s):

Cardiac Surgery ◽

Extracorporeal Membrane Oxygenation ◽

Cardiac Catheterization ◽

Congenital Heart ◽

Heart Surgery ◽

Congenital Heart Surgery ◽

Ecmo Support ◽

Congenital Cardiac Surgery ◽

Membrane Oxygenation ◽

Successful Weaning

Abstract Background: Cardiac catheterization performed for patients supported by extracorporeal membrane oxygenation (ECMO) after congenital heart surgery may affect their clinical outcome, yet its effect in this group of patients is not adequately studied. The objective of this study was the evaluation of the impact of cardiac catheterization on successful weaning from ECMO support and survival after congenital heart surgery and determining predictors that influence successful weaning. Methods : This is a retrospective cohort study conducted on paediatric patients underwent cardiac catheterization while on ECMO support after congenital heart surgery in two cardiac centres from November 2012 till February 2020. Predictors of successful weaning from ECMO support were studied using univariable and multivariable logistic regression analysis. Results: Out of 141 patients received ECMO support after congenital cardiac surgery,60 patients underwent 60 cardiac catheterizations (31 diagnostic and 29 interventional). The median age was 6.5 months (range 4 days -20 years), median weight was 5 kg (range 2-53 kg). Thirty-four patients (56.7%) underwent successful decannulation from ECMO support and 22patients (36.3%) survived to hospital discharge. Predictors of successful weaning from ECMO support and survival were shorter duration on ECMO support, absence of bleeding tendency, early cardiac catheterization, and biventricular physiology. Conclusion: Cardiac catheterization is feasible with acceptable risks for patients receiving ECMO after congenital heart surgery. The shorter duration on ECMO support may have a significant influence on successful weaning from ECMO and survival after congenital heart surgery. Early cardiac catheterization could also influence the successful weaning from ECMO.

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