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Complications of paediatric interventional catheterisation: an analysis of risk factors

Published online by Cambridge University Press:  13 July 2005

Gabriella Agnoletti ,
Caroline Bonnet ,
Younes Boudjemline ,
Christine Le Bihan ,
Damien Bonnet ,
Daniel Sidi  and
Philipp Bonhoeffer
Gabriella Agnoletti
Affiliation:
Service de Cardiologie Pédiatrique, Necker Enfants Malades, Paris, France
Caroline Bonnet
Affiliation:
Service de Cardiologie Pédiatrique, Necker Enfants Malades, Paris, France
Younes Boudjemline
Affiliation:
Service de Cardiologie Pédiatrique, Necker Enfants Malades, Paris, France
Christine Le Bihan
Affiliation:
Service de Biostatistique et Informatique, Necker Enfants Malades, Paris, France
Damien Bonnet
Affiliation:
Service de Cardiologie Pédiatrique, Necker Enfants Malades, Paris, France
Daniel Sidi
Affiliation:
Service de Cardiologie Pédiatrique, Necker Enfants Malades, Paris, France
Philipp Bonhoeffer
Affiliation:
Cardiothoracic Unit, Great Ormond Street Hospital, London, United Kingdom
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Abstract

Objectives: To identify predictive factors of complications occurring during paediatric interventional catheterisation. Background: Interventional paediatric catheterisation is still burdened by a substantial risk. Risk factors, however, have rarely been investigated. Methods: We analysed prospectively 1,022 interventional procedures performed over a period of 8 years, excluding 260 procedures for atrial septostomy. We considered several patient-related variables, specifically age, weight, and gender, type of procedure, times required for fluoroscopy and the overall procedure, technical challenge, and the severity of the clinical condition. We also analysed variables linked to the environment, specifically the date of the examination, whether the operator remained in training, the novelty of the material, any breakdown in the installation, and errors made by the operator. We classified complications as those without clinical consequence, those which proved lethal, those requiring cardiopulmonary resuscitation, elective or emergency surgery, hospitalisation in the intensive care unit, and those leading to recatheterisation. Results: Our average incidence of complications was 4.1 per cent, which did not change significantly during the period of study. Of the patients, 4 died, 7 needed urgent surgery, 5 elective surgery, 3 hospitalisation in intensive care unit, and 8 recatheterisation. Independent risk factors for complications were technical challenge, critical clinical condition, operator in training, operator error, and breakdown of the installation. Young age was not associated with a higher risk of complications. Patients in whom no cause for complication could be found, either related to their own features or the environment, had a risk of complication of 1.4 per cent (95 per cent confidence intervals from 0.7 to 2.5 per cent). Conclusions: Our data show that variables relating either to the patient or the environment of catheterisation are associated with an increased risk of procedural complications. Knowledge of the risk factors can improve the odds of paediatric interventional catheterisation.

Keywords

Congenital heart diseasecatheterisationpredictive factors
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 4 , August 2005 , pp. 402 - 408
Copyright
© 2005 Cambridge University Press

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References

Vitiello R, McCrindle BW, Nykanen D, Freedom R, Benson L. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 1433–1440.Google Scholar
Fellows KE, Radtke W, Keane JF, Lock JE. Acute complications of catheter therapy for congenital heart disease. Am J Cardiol 1987; 60: 679–683.Google Scholar
Cassidy SC, Schmidt KG, Van Hare GF, Stanger P, Teitel DF. Complications of pediatric cardiac catheterization: a 3-year study. J Am Coll Cardiol 1992; 19: 1285–1293.Google Scholar
Booth P, Redington AN, Shinebourne EA, Rigby ML. Early complications of interventional balloon catheterisation in infants and children. Br Heart J 1991; 65: 109–112.Google Scholar
Stanger P, Heyman MA, Tarnoff H, Hoffman JE, Rudolf AM. Complications of cardiac catheterization in neonates, infants and children. A three-year study. Circulation 1974; 50: 595–608.Google Scholar
Braunwald E, Gorlin R, McIntosh HD, Ross RS, Rudolph AM, Swan HJC. Cooperative study on cardiac catheterization. Circulation 1968; 37 (Suppl III): 59–66.Google Scholar
Cohn HE, Freed MD, Hellenbrand WF, Fyler DC. Complications and mortality associated with cardiac catheterisation in infants under 1 year: a prospective study. Pediatr Cardiol 1985; 6: 123–131.Google Scholar
Ho CS, Krovetz JL, Rowe RD. Major complications of cardiac catheterization and angiocardiography in infants and children. Hopkins Med J 1972; 131: 247–258.Google Scholar
McElhinney DB, Reddy VM, Moore P, Brook MM, Hanley FL. Surgical intervention for complications of transcatheter dilation procedures in congenital heart disease. Ann Thorac Surg 2000; 69: 858–864.Google Scholar
Kocis KC, Snider AR, Vermilion RP, Beekman RH. Two-dimensional and Doppler ultrasound evaluation of femoral arteries in infants after cardiac catheterization. Am J Cardiol 1995; 75: 640–645.Google Scholar
Qureshi SA, Redington AN, Wren C, et al. Recommendations of the British Paediatric Cardiac Association for therapeutic cardiac catheterisation in congenital cardiac disease. Cardiol Young 2000; 10: 649–667.Google Scholar