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CLINICAL STUDIES

Complications associated with pediatric cardiac catheterization

^a Department of Pediatrics, Division of Cardiology, and the Variety Club Cardiac Catheterization Laboratories, The University of Toronto School of Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada

Manuscript received October 28, 1997; revised manuscript received June 25, 1998, accepted July 15, 1998.

Address for correspondence: Dr. Lee Benson, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
benson{at}sickkids.on.ca

Objectives. The aim of this study was to determine the relative risks of pediatric diagnostic, interventional and electrophysiologic catheterizations.

Background. The role of the pediatric catheterization laboratory has evolved in the last decade as a therapeutic modality, although remaining an important tool for anatomic and hemodynamic diagnosis.

Methods. A study of 4,952 consecutive pediatric catheterization procedures was undertaken.

Results. Patient ages ranged from 1 day to 20 years (median 2.9 years). One or more complications occurred in 436 studies (8.8%) and were classified as major in 102 and minor in 458, with vascular complications (n = 189; 3.8% of procedures) the most common adverse event. Arrhythmic complications (n = 24) were the most common major complication. Death occurred in seven cases (0.14%) as a direct complication of the procedure and was more common in infants (n = 5). Independent risk factors for complications included a young patient age and undergoing an interventional procedure.

Conclusions. Complications continue to be associated with pediatric cardiac catheterization. Efforts should be directed to improving equipment for flexibility and size, and finding alternative methods for vascular access. Patient age and interventional studies are risk factors for morbidity and mortality.

Abbreviations and Acronyms   DGN = diagnostic   EP = electrophysiologic sudy   INTV = interventional

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