Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T17:53:55.523Z Has data issue: false hasContentIssue false
  • English
  • Français

Safety of outpatient cardiac catheterisation in infants with single-ventricle or shunt-dependent biventricular congenital heart disease

Published online by Cambridge University Press:  12 October 2018

Jamie N. Colombo ,
Michael C. Spaeder  and
Michael R. Hainstock
Jamie N. Colombo*
Affiliation:
Department of Pediatrics, Division of PediatricCardiology, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
Michael C. Spaeder
Affiliation:
Division of Pediatric Critical Care, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
Michael R. Hainstock
Affiliation:
Division of Pediatric Cardiology, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
*
Author for correspondence: Jamie N. Colombo, DO, 1501 N. Campbell Ave., PO Box 245073, Tucson, AZ 85724, USA. Tel: 520-626-5585; Fax: 520-626-6571; E-mail: jamiecolombo@peds.arizona.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

We aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation.

Background

Cardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres. Outpatient catheterisation reduces parental anxiety and decreases cost. Our institutional strategy is to discharge patients following a 4- to 6-hour post-procedure observation period.

Methods

Retrospective cohort study using the Society of Thoracic Surgeons Database identified patients <1 year of age with pre-stage II single-ventricle CHD or shunt-dependent biventricular CHD who underwent cardiac catheterisation between 2007 and 2015. Readmission was defined as admission to the hospital within 48 hours after discharge after catheterisation.

Results

A total of 92 patients were included in the analysis. Among them, 62 patients (67%) were discharged after a 4- to 6-hour observation period with only 3% readmission, 18 patients (20%) stayed for a 23-hour observation period, and 12 patients (13%) were admitted for >23 hours. There were no differences in baseline characteristics between discharged and admitted patients. Patients who underwent intervention were more likely to be admitted. Patients with hypoplastic left heart syndrome did not have major adverse events or readmissions. No intra- or peri-procedural deaths occurred.

Conclusions

Outpatient cardiac catheterisation may be a safe option for infants with single-ventricle and shunt-dependent biventricular CHD, with low readmission rates and minimal morbidity.

Keywords

CHDsingle ventriclehypoplastic left heart syndromecardiac catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 12 , December 2018 , pp. 1444 - 1451
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Gordon, BM, Rodriguez, S, Lee, M, et al. Decreasing number of deaths of infants with hypoplastic left heart syndrome. J Pediatr 2008; 153: 354–358.Google Scholar
2. Brown, DW, Mangeot, C, Anderson, JB, et al. Digoxin use is associated with reduced interstage mortality in patients with no history of arrhythmia after stage I palliation for single ventricle heart disease. J Am Heart Assoc 2016; 5: e002376.Google Scholar
3. Oster, ME, Kelleman, M, McCracken, C, et al. Association of digoxin with interstage mortality: results from the pediatric heart network single ventricle reconstruction trial public use dataset. J Am Heart Assoc 2016; 5: e002566–e002566.Google Scholar
4. Goldstein, BH, Holzer, RJ, Trucco, SM, et al. Practice variation in single-ventricle patients undergoing elective cardiac catheterization: a report from the congenital cardiac catheterization project on outcomes (C3PO). Congenit Heart Dis 2016; 11: 122–135.Google Scholar
5. Figliali, S, Krajcer, Z, Gonzales-Camid, F, et al. Safety of outpatient cardiac catheterization. Chest 1985; 88: 349–351.Google Scholar
6. Block, PC, Ockene, I, Goldberg, RJ, et al. A prospective randomized trial of outpatient versus inpatient cardiac catheterization. N Engl J Med 1988; 319: 1251–1255.Google Scholar
7. Arpagaus, M, Gray, D, Zierler, B. Cardiac catheterization in children as outpatients: potential, eligibility, safety and costs. Cardiol Young 2003; 13: 275–283.Google Scholar
8. Cumming, GR. Cardiac catheterization in infants and children. Am J Cardiol 1982; 49: 1248–1253.Google Scholar
9. Clark, DA, Moscovich, MD, Vetrovec, GW. Guidelines for the performance of outpatient catheterization and angiographic procedures. Catheter Cardiovasc Interv 1992; 7: 7–9.Google Scholar
10. Waldman, JD, Young, TS, Pappelbaum, SJ, et al. Pediatric cardiac catheterization with same-day discharge. Am J Cardiol 1982; 50: 800–803.Google Scholar
11. Cumming, R. Sci H. Cardiac catheterization in infants and children can be an outpatient procedure. Am J Cardiol 1992; 49: 1248–1253.Google Scholar
12. Bove, T, Vandekerckhove, K, Panzer, J, et al. Disease-specific outcome analysis of palliation with the modified Blalock–Taussig shunt. World J Pediatr Congenit Hear Surg 2015; 6: 67–74.Google Scholar
13. Gladman, G, McCrindle, BW, Williams, WG, et al. The modified Blalock–Taussig shunt: clinical impact and morbidity in Fallot’s tetralogy in the current era. J Thorac Cardiovasc Surg 1997; 114: 25–30.Google Scholar
14. Feinstein, JA, Benson, DW, Dubin, AM, et al. Hypoplastic left heart syndrome. J Am Coll Cardiol 2012; 59: S1–S42.Google Scholar
15. Goldberg, CS, Schwartz, EM, Brunberg, JA, et al. Neurodevelopmental outcome of patients after the Fontan operation: a comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions. J Pediatr 2000; 137: 646–652.Google Scholar
16. Mehta, R, Lee, K-J, Chaturvedi, R, et al. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 2008; 72: 278–285.Google Scholar
17. D’Udekem, Y, Xu, MY, Galati, JC, et al. Predictors of survival after single-ventricle palliation: the impact of right ventricular dominance. J Am Coll Cardiol 2012; 59: 1178–1185.Google Scholar