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Cardiac catheterisation in infants weighing less than 2500 grams

Published online by Cambridge University Press:  18 April 2005

Colin J. McMahon ,
Jack F. Price ,
Jack C. Salerno ,
Howaida El-Said ,
Michael Taylor ,
Thomas A. Vargo  and
Michael R. Nihill
Colin J. McMahon
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Jack F. Price
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Jack C. Salerno
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Howaida El-Said
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Michael Taylor
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Thomas A. Vargo
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
Michael R. Nihill
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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Abstract

Objectives: To investigate the indications for, and outcome of, cardiac catheterisation in infants weighing less than 2500 g at a single institution over an 8-year period. Patients and Methods: We assessed all infants who were less than 2500 g at the time of cardiac catheterisation at Texas Children's Hospital from January 1993 to January 2001. Comparisons of morbidity and mortality were drawn with an equivalent number of infants of similar age weighing greater than 2500 g seen over the same period of time. Results: We performed interventional procedures in 22, and diagnostic catheterisations in 12 infants weighing less than 2500 g. Interventions included pulmonary valvoplasty in six patients, balloon angioplasty of critical coarctation in one, aortic valvoplasty in two, septostomy in ten, and coil occlusion of an arteriovenous malformation, redirection of a subclavian venous line, and coil occlusion of a patent arterial duct in one patient each. The median age at catheterisation was 5 days for children less than 2500 g, and 10 days for those above 2500 g. The median weights were 2.3 kg and 3.3 kg, and the median gestational ages were 35 weeks and 38 weeks, for the two respective groups. Of those weighing less than 2500 g, two died (6%), with no deaths occurring in those weighing more than 2500 g. In 3 patients weighing less than 2500 g (9%), there was vascular compromise, one child with bilateral femoral venous obstruction requiring fasciotomy compared, to one in the group weighing greater than 2500 g (2%). Conclusion: There is a significantly increased risk of mortality and vascular compromise in infants weighing less than 2500 g. Interventional catheterisation in these infants may be lifesaving, but given the aforementioned risks, diagnostic catheterisation should be deferred if possible in favor of noninvasive modalities.

Keywords

Cardiac catheterizationinterventionslow birth weight
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 2 , April 2003 , pp. 117 - 122
Copyright
© 2003 Cambridge University Press

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