SINGLE OPERATOR EXPERIENCE OF CARDIAC CATHETERIZATION AND INTERVENTIONS IN CONGENITAL HEART DISEASES OVER TWO YEARS AT AFIC – CASE ASSORTMENT AND VASCULAR COMPLICATIONS

Objective: This study elucidates single operator performed, contemporary experience of percutaneous cardiac interventions and diagnostic catheter studies in patients with CHD with focus on individual case selection, approach and vascular complications. Study Design: Prospective study. Place and Duration of Study: Department of Paediatric Cardiology, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, (AFIC/NIHD) Rawalpindi, from Jul 2017 to Jun 2019. Methodology: Total consecutive 574 patients, who were selected & underwent cardiac catheterization for various CHDs by single operator. Results: The author performed total of 574 cardiac catheter procedures during study period including both diagnostic and interventions in various CHDs. Mean age was 8.8 years, mean weight 22 kg and mean height was 106.3 cms. 59% cases were done under general anesthesia and 51% of patient population was male. Diagnostic procedures constituted 51% of total cases with most common indication being the Tetralogy of Fallot. 284 interventional procedures done in 280 patients included Patent ductusarteriosus device closure (n=86), Atrial Septal defect device closure (n=52) and Pulmonary valve ballooning (n=39). In four patients, two interventions were done in same catheter procedure. Transient vascular complications occurred in 4.5% of the cases. Conclusion: Cardiac catheterization in CHDs is generally efficacious and a safe procedure. Young infants are specifically at high risk of vascular complications.

[1]  A. Pillai,et al.  Transcatheter Closure of Moderate to Large Perimembranous Ventricular Septal Defects in Children Weighing 10 kilograms or less , 2019, World journal for pediatric & congenital heart surgery.

[2]  I. El-rassi,et al.  Transcatheter Closure of Atrial Septal Defects: Comparable Experience and Outcomes Between Developing and Developed Countries , 2019, Pediatric Cardiology.

[3]  M. Sabri,et al.  The efficacy and safety of using amplatzer for transcatheter closure of atrial septal defect in small children with less than 10 kg , 2019, ARYA atherosclerosis.

[4]  M. Maleki,et al.  Self-Expanding Versus Balloon-Expandable Stents in Patients With Isthmic Coarctation of the Aorta. , 2018, The American journal of cardiology.

[5]  Reham Wagdy The role of diagnostic cardiac catheterization for children with congenital heart diseases: local experience , 2018, Archives of medical sciences. Atherosclerotic diseases.

[6]  D. Barron,et al.  Stenting of the Right Ventricular Outflow Tract Promotes Better Pulmonary Arterial Growth Compared With Modified Blalock-Taussig Shunt Palliation in Tetralogy of Fallot-Type Lesions. , 2017, JACC. Cardiovascular interventions.

[7]  Chang-Ha Lee,et al.  The effect of balloon valvuloplasty for bioprosthetic valve stenosis at pulmonary positions , 2017, Congenital heart disease.

[8]  S. Schubert,et al.  Interventional VSD-Closure with the Nit-Occlud® Lê VSD-Coil in 110 Patients: Early and Midterm Results of the EUREVECO-Registry , 2017, Pediatric Cardiology.

[9]  T. Geva,et al.  Advances in pediatric cardiac MRI , 2016, Current opinion in pediatrics.

[10]  M. Younas,et al.  Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus , 2016, Pakistan journal of medical sciences.

[11]  G. Gorincour,et al.  Cardiac CT or MRI in pediatric practice: Which one to choose? , 2016, Diagnostic and interventional imaging.

[12]  S. Ali Adverse events in pediatric cardiac catheterization: Initial experience of Sohag university hospital , 2016 .

[13]  F. Jaw,et al.  Trends in the utilization of computed tomography and cardiac catheterization among children with congenital heart disease , 2014, Journal of the Formosan Medical Association.

[14]  Taliha Oner,et al.  Complications of cardiac catheterization in pediatric patients: a single center experience. , 2012, The Turkish journal of pediatrics.

[15]  T. Yagihara,et al.  Complications of pediatric cardiac catheterization and system of catheterization laboratories minimizing complications--a Japanese multicenter survey. , 2010, Journal of cardiology.

[16]  P. Bonhoeffer,et al.  Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction , 2000, The Lancet.

[17]  G. V. Van Hare,et al.  Complications of pediatric cardiac catheterization: a 3-year study. , 1992, Journal of the American College of Cardiology.

[18]  A. Hastreiter,et al.  Balloon atrial septostomy in congenital heart disease. , 1969, Medical times.

[19]  E. Zahn,et al.  Overview of transcatheter patent ductus arteriosus closure in preterm infants , 2019, Congenital heart disease.

[20]  Rizwana Rehman,et al.  Stenting the complex patent ductus arteriosus in tetralogy of Fallot with pulmonary atresia: challenges and outcomes. , 2018, Future cardiology.

[21]  S. Kulkarni,et al.  Vascular ultrasound imaging to study immediate postcatheterization vascular complications in children. , 2006, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.