Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T06:20:59.425Z Has data issue: false hasContentIssue false

Paediatric cardiac catheterisation in Norway: rates and types of complications in new terms

Published online by Cambridge University Press:  08 March 2017

Maren E. A. Ravndal
Affiliation:
Faculty of Medicine, University of Oslo, Oslo, Norway
Anders H. Christensen
Affiliation:
Pediatric Department, Oslo University Hospital (OUS), Oslo, Norway
Gaute Døhlen
Affiliation:
Pediatric Department, Oslo University Hospital (OUS), Oslo, Norway
Henrik Holmstrøm*
Affiliation:
Faculty of Medicine, University of Oslo, Oslo, Norway Pediatric Department, Oslo University Hospital (OUS), Oslo, Norway
*
Correspondence to: H. Holmstrøm, Pediatric Cardiologist, Professor Unit of Pediatric Cardiology Division of Paediatric and Adolescent Medicine, Oslo University Hospital (Rikshospitalet), Postbox 4950 Nydalen, 0424 Oslo, Norway. Tel: +47 23074541, exp: +47 23072317; Fax: +47 23072330; E-mail: henrik.holmstrom@ous-hf.no

Abstract

We determined the incidence, type, and severity of complications after cardiac catheterisation in children with heart disease in Norway, and we present the results in terms of the International Paediatric and Congenital Cardiac Code (IPCCC) nomenclature for complications. All paediatric cardiac catheterisations in Norway are performed in one clinical centre. All procedures performed during a 5-year period beginning in 2010 were prospectively registered, and medical records for cases with complications were reviewed to confirm the event and to re-classify the type, severity, and attributability of the complication according to the IPCCC nomenclature. Univariate and multivariate analyses were performed to identify possible risk predictors. A total of 1318 catheterisations performed on 941 patients were included in the present study, of which 68% were interventional. The complication and major complication rates were 5.5 and 1.4%, respectively. Trauma to the vessels or the myocardium, haemodynamic adverse events, and arrhythmias were the most common types of complications. In the multivariate model, weight <4 kg (odds ratios, 3.0; 95% confidence intervals: 1.6–5.8) and risk category 5 (odds ratios, 5.1; 95% confidence intervals: 2.1–12.3) were significant risk predictors for any complication. In spite of a high rate of interventions, the complication rates in this study were similar to older studies, but diverging methods and terminology limit the comparability. We strongly suggest general use of the proposed IPCCC classification system for registration and reports of complications for paediatric cardiac catheterisations.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

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. Agnoletti, G, Bonnet, C, Boudjemline, Y, et al. Complications of paediatric interventional catheterisation: an analysis of risk factors. Cardiol Young 2005; 15: 402408.CrossRefGoogle ScholarPubMed
2. Bergersen, L, Gauvreau, K, Jenkins, KJ, Lock, JE. Adverse event rates in congenital cardiac catheterization: a new understanding of risks. Congenit Heart Dis 2008; 3: 90105.CrossRefGoogle ScholarPubMed
3. Kobayashi, D, Sallaam, S, Aggarwal, S, et al. Catheterization-based intervention in low birth weight infants less than 2.5 kg with acute and long-term outcome. Catheter Cardiovasc Interv 2013; 82: 802810.CrossRefGoogle ScholarPubMed
4. Mobley, MM, Stroup, RE, Kaine, SF. Comparative risk of cardiac catheterisations performed on low birth weight neonates. Cardiol Young 2013; 23: 722726.CrossRefGoogle ScholarPubMed
5. Yilmazer, MM, Ustyol, A, Guven, B, et al. Complications of cardiac catheterization in pediatric patients: a single center experience. Turk J Pediatr 2012; 54: 478485.Google Scholar
6. Mehta, R, Lee, KJ, Chaturvedi, R, Benson, L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 2008; 72: 278285.Google Scholar
7. Stanger, P, Heymann, MA, Tarnoff, H, Hoffman, JI, Rudolph, AM. Complications of cardiac catheterization of neonates, infants, and children. A three-year study. Circulation 1974; 50: 595608.Google Scholar
8. Vitiello, R, McCrindle, BW, Nykanen, D, Freedom, RM, Benson, LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32: 14331440.CrossRefGoogle ScholarPubMed
9. Bergersen, L, Giroud, JM, Jacobs, JP, et al. Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 2 – nomenclature of complications associated with interventional cardiology). Cardiol Young 2011; 21: 260265.CrossRefGoogle ScholarPubMed
10. Bergersen, L, Everett, AD, Giroud, JM, et al. Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 1 – procedural nomenclature). Cardiol Young 2011; 21: 252259.Google Scholar
11. Mori, Y, Takahashi, K, Nakanishi, T. Complications of cardiac catheterization in adults and children with congenital heart disease in the current era. Heart Vessels 2013; 28: 352359.CrossRefGoogle ScholarPubMed
12. Phillips, BL, Cabalka, AK, Hagler, DJ, Bailey, KR, Cetta, F. Procedural complications during congenital cardiac catheterization. Congenit Heart Dis 2010; 5: 118123.Google Scholar
13. Bergersen, L, Gauvreau, K, Foerster, SR, et al. Catheterization for Congenital Heart Disease Adjustment for Risk Method (CHARM). JACC Cardiovasc Interv 2011; 4: 10371046.CrossRefGoogle ScholarPubMed
14. Lin, CH, Hegde, S, Marshall, AC, et al. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease. Pediatr Cardiol 2014; 35: 140148.CrossRefGoogle ScholarPubMed
15. Backes, CH, Bergersen, L, Rome, JJ, et al. Quality metrics in cardiac catheterization for congenital heart disease: utility of 30-day mortality. Catheter Cardiovasc Interv 2015; 85: 104110.CrossRefGoogle Scholar
16. Bergersen, L, Gauvreau, K, Marshall, A, et al. Procedure-type risk categories for pediatric and congenital cardiac catheterization. Circ Cardiovasc Interv 2011; 4: 188194.CrossRefGoogle ScholarPubMed
17. Vincent, RN, Moore, J, Beekman, RH, et al. Procedural characteristics and adverse events in diagnostic and interventional catheterisations in paediatric and adult CHD: initial report from the IMPACT Registry. Cardiol Young 2015: 19.Google Scholar
18. 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: 12851293.CrossRefGoogle Scholar
19. Holzer, RJ, Gauvreau, K, Kreutzer, J, Moore, JW, McElhinney, DB, Bergersen, L. Relationship between procedural adverse events associated with cardiac catheterization for congenital heart disease and operator factors: results of a multi-institutional registry (C3PO). Catheter Cardiovasc Interv 2013; 82: 463473.Google Scholar
20. Bergersen, L, Marshall, A, Gauvreau, K, et al. Adverse event rates in congenital cardiac catheterization – a multi-center experience. Catheter Cardiovasc Interv 2010; 75: 389400.Google Scholar
21. Bergersen, L, Gauvreau, K, Lock, JE, Jenkins, KJ. A risk adjusted method for comparing adverse outcomes among practitioners in pediatric and congenital cardiac catheterization. Congenit Heart Dis 2008; 3: 230240.CrossRefGoogle ScholarPubMed
22. Jayaram, N, Beekman, RH 3rd, Benson, L, et al. Adjusting for risk associated with pediatric and congenital cardiac catheterization: a report from the NCDR IMPACT Registry. Circulation 2015; 132: 18631870.CrossRefGoogle ScholarPubMed
23. Backes, CH, Cua, C, Kreutzer, J, et al. Low weight as an independent risk factor for adverse events during cardiac catheterization of infants. Catheter Cardiovasc Interv 2013; 82: 786794.CrossRefGoogle ScholarPubMed
24. Rhodes, JF, Asnes, JD, Blaufox, AD, Sommer, RJ. Impact of low body weight on frequency of pediatric cardiac catheterization complications. Am J Cardiol 2000; 86: 12751278; A9.CrossRefGoogle ScholarPubMed
Supplementary material: File

Ravndal supplementary material S1

Ravndal supplementary material

Download Ravndal supplementary material S1(File)
File 78.6 KB
Supplementary material: File

Ravndal supplementary material S2

Ravndal supplementary material

Download Ravndal supplementary material S2(File)
File 103.9 KB