Adverse events during diagnostic and therapeutic pediatric cardiac catheterization

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Armando Zepeda-Arámbula
Lorenzo Gutiérrez-Cobian
Jorge Luis Villatoro-Fernández
Sandra Livier Pacheco-López
Alberto Tlacuilo-Parra

Keywords

Cardiac catheterization, Congenital heart defects, Postoperative complications, Mortality

Abstract

Background: The aim of this paper is to determine the frequency of adverse events during heart catheterization, in both categories diagnostic and therapeutic procedures in children.

Methods: We review the clinical charts of those patients undergoing heart catheterization during the period from May 1 to October 31, 2014, in order to determine the frequency of adverse events presented within the first 24 hours after the procedure.

Results: During the six month period, 143 procedures were performed, of which 126 met the inclusion criteria. According to the type of procedure we divide it in: diagnostic 68 (54%) and therapeutic 58 (46%). Adverse effects were developed in 16 patients (13%), 11.7% during diagnostic and 14% within the therapeutic procedures. The adverse events were classified as serious in 7 (5.5%), endangering the live in 5 (3.9%) and catastrophic in only one (0.79%). Those factors associated with the development of an adverse event were: age less than one year-old (OR = 5.45), unscheduled admission to the procedure (OR = 1.2) and use of inotropic drugs (OR = 7). 

Conclusions: Cardiac catheterization performed in our facility is a safe procedure, with a percentage of adverse events similar to that reported worldwide. It is essential to make a proper and comprehensive assessment of the patient before the procedure, considering stratification according to risk categories and assessing the state of gravity of the children.

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References

Instituto Nacional de Estadística y Geografía. Tasa bruta de natalidad 2013 (base de datos por línea). México: Censo de población 2010, (actualización 09/02/15; fecha de consulta 05/04/15). Disponible en: www.inegi.org.mx.

 

Mendieta-Alcántara G, Santiago-Alcántara E, Mendieta-Zerón H, Dorantes-Piña R, Ortiz de Zárate-Alarcón G, Otero-Ojeda GA. Incidencia de las cardiopatías congénitas y los factores asociados a la letalidad en niños nacidos en dos hospitales del Estado de México. Gac Med Mex. 2013;149(6):617-623.

 

Calderón-Colmenero J, Cervantes-Salazar JL, Curi-Curi PJ, Ramírez-Marroquín S. Problemática de las cardiopatías congénitas en México, propuesta de regionalización. Arch Cardiol Mex. 2010;80(2): 133-140. 

 

Botto L, Goldmuntz E. Epidemiology and Prevention of Congenital Heart Defects; En: Allen H, Driscoll D, Shaddy R (Editores). Moss and Adams. Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. 7a ed. Philadelphia: Lippincott Williams and Wilkins; 2008. pp. 525-545.

 

Sistema Nacional de Información en Salud. (Base de datos en línea). México: Mortalidad 2000-2008 (fecha de actualización 2008; fecha de consulta 14/04/2015). Disponible en: www.sinais.salud.gob.mx. 

 

García Montes JA. Cateterismo diagnóstico en cardiopatías congénitas del adulto. Arch Cardiol Mex. 2006;76(Supl. 2):137-140. 

 

Moreno Martínez FL, Echarte Martínez JC. Indicaciones de cateterismo cardíaco. Cor Salud. 2009;1: 25-36.

 

Serrano Aísa PJ, Portero Pérez MP, Aguarón López V, Peleato Peleado A, Ferreira Montero IJ. Cateterismo cardíaco y procedimientos intervencionistas. Clin Invest Arterioscl. 2002;14:156-165.

 

Zabal C. El cateterismo intervencionista en las cardiopatías congénitas. Arch Cardiol Mex. 2001;71: 188-191.

 

Rashkind WJ, Miller WW. Creation of an atrial septal defect without thoracotomy: palliative approach to complete transposition of the great arteries. JAMA. 1966;196(11):991-992.

 

Bergersen L, Gauvreau K, Marshall A, Kreutzer J, Beekman R. Procedure-type risk categories for pediatric and congenital cardiac catheterization. Circ Cardiovasc Interv. 2011;4(2):188-194.

 

Laussen PC, Salvin J. Diagnostic and Therapeutic Cardiac Catheterization. En: Fuhrman BP, Zimmerman JJ. Pediatric Critical Care. 4ta Ed. Philadelphia: Elsevier Saunders; 2011. pp. 266-276.

 

Bergersen L, Gauvreau K, Foerster SR, Marshall AC, McElhinney DB, Beekman RH, et al. Catheterization for congenital heart disease adjustment for risk method (CHARM). JACC Cardiovasc Interv. 2011;4(9):1038-1046.

 

Lin CH, Hegde S, Marshall AC, Porras D, Gauvreau K, Balzer DT et al. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease. Pediatr Cardiol. 2014;35(1):140-148.

 

Bergersen L, Marshall A, Gauvreau K, Beekman R, Hirsch R, Foerster S et al. Adverse event rates in congenital cardiac catheterization - a multi-center experience. Catheter Cardiovasc Interv. 2010;75(3): 389-400.

 

Garcia H, Ramos-Jimenez A, Villegas-Silva R, Rodriguez L, Vera-Canelo M. Post-discharge survival of newborn infants with congenital cardiopathies undergoing heart surgery or interventional catheterization. Rev Invest Clin. 2002;54:311-319.

 

Zabal-Cerdeira C, Garcia-Montes JA, Sandoval-Jones JP, Calderon-Colmenero J, Patiño-Bahena J, Juanico-Enriquez A, Buendía-Hernandez A. Percutaneous closure of atrial septal defects with the Amplatzer device: 15 years of experience. Arch Cardiol Mex. 2014;84(4):250-255.

 

Bergersen L, Gauvreau K, McElhinney D, Fenwick S, Kirshner D, Harding J et al. Capture of complexity of specialty care in pediatric cardiology by work RVU. Pediatrics. 2013;131:258-267.