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Cardiac catheterization in infants weighing less than 1,500 grams

Catheterization and cardiovascular interventions, 2006-12, Vol.68 (6), p.948-956 [Peer Reviewed Journal]

Copyright © 2006 Wiley‐Liss, Inc. ;ISSN: 1522-1946 ;EISSN: 1522-726X ;DOI: 10.1002/ccd.20905 ;PMID: 17086522

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  • Title:
    Cardiac catheterization in infants weighing less than 1,500 grams
  • Author: Sutton, Nicole ; Lock, James E. ; Geggel, Robert L.
  • Subjects: Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - methods ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - methods ; Case-Control Studies ; Heart Defects, Congenital - surgery ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; pediatric cardiac catheterization ; pediatric catheterization complication ; pediatric interventional catheterization ; Retrospective Studies
  • Is Part Of: Catheterization and cardiovascular interventions, 2006-12, Vol.68 (6), p.948-956
  • Description: Background: The improved survival of very low‐birth‐weight (<1,500 g) infants justifies more aggressive attempts to treat underlying congenital heart disease than in the past. Methods: We retrospectively reviewed all catheterizations performed at our institution between January 1, 1990 and June 1, 2004 in infants weighing <1,500 g. We performed a 3:1 case–control study. Comparisons were randomly selected from a group of patients catheterized within 6 months of the cases and weighing 2–3 kg. All catheterization data, angiograms, and hospital charts were reviewed. Results: Eighteen patients weighing <1,500 g underwent catheterization. Fifty‐four patients were selected as comparisons. There were no significant differences in the age at catheterization, procedure time, fluoroscopy time, or contrast amount (cc/kg). The lower‐birth‐weight infants were more likely to be premature (median age 29 vs. 37 weeks, P < 0.001), and to have left‐sided obstructive lesions including aortic stenosis or coarctation. The comparison patients were more likely to be postoperative (28% vs. 0%, P = 0.02), and included a higher number with hypoplastic left heart syndrome. There was an increased incidence of interventions performed in the lower‐birth‐weight infants (83% vs. 41%, P = 0.002). There was a difference in the interventions performed between the two groups: the comparisons had more atrial septal procedures, and the lower‐birth‐weight infants had more coarctation dilations and aortic valve dilations. There were no significant differences in the acute success rate of the procedures (100% vs. 95%), overall complication rate (56 vs. 57%), incidence of blood transfusions (44 vs. 30%), or major complications (11 vs. 13%) between the lower‐birth‐weight and comparison groups respectively. There was a trend towards higher survival rate in the comparison group in this small study population, but it did not reach significance (80 vs. 61%, P = 0.13). Conclusions: Cardiac catheterization in neonates <1,500 g is more likely to include percutaneous intervention, especially on the left side, but is generally successful with a complication rate similar to procedures performed in larger infants. Although these procedures are rare, improved miniaturization of equipment would facilitate safer interventions. © 2006 Wiley‐Liss, Inc.
  • Publisher: Hoboken: Wiley Subscription Services, Inc., A Wiley Company
  • Language: English
  • Identifier: ISSN: 1522-1946
    EISSN: 1522-726X
    DOI: 10.1002/ccd.20905
    PMID: 17086522
  • Source: MEDLINE
    Alma/SFX Local Collection
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