[Complications of two series of 1000 each heart catheterization studies in childhood].
Two series of 1,000 consecutive cardiac catheterizations in neonates, infants and older children were prospectively investigated with respect to catheter-induced complications. These were categorized into arrhythmias, vascular complications, catheter and contrast perforations, central nervous (CNS) complications, clinical deterioration and catheter-related death. Comparing series 1 and 2, the number of arrhythmias decreased from 7.6% to 5.0%, acute vascular complications decreased from 2.1% to 1.4%, the number of patients showing clinical deterioration from 2.6% to 0.6% and CNS complications from 0.4% to 0.1%, whereas catheter or contrast perforations-remained virtually constant at 0.4% and 0.5% respectively. Catheter-induced mortality decreased from 2.0% to 0.7%. The group of neonates showed the greatest reduction in serious complications and catheter-induced mortality (31.3% to 12.4% and 11.0% to 4.4%, respectively). Increasing experience of the investigators, introduction of two-dimensional echocardiography as a supplementary investigation or even catheter substitute, use of percutaneous catheterization and sheath techniques, introduction of E-type prostaglandins and increased use of intubation and anaesthesia for catheterization all played an important role in the improvement shown in this investigation. Complications are still mainly seen in the group of neonates and cyanotic patients.
Beitzke
A
A
Department für Kardiologie, Universitäts-Kinderklinik, Graz.
Mache
C J
CJ
Stein
J I
JI
Suppan
C
C
D001145:Arrhythmias, Cardiac / Q000401:mortality; D001916:Brachial Artery / Q000293:injuries; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000401:mortality; D002423:Cause of Death; D005263:Femoral Artery / Q000293:injuries; D005268:Femoral Vein / Q000293:injuries; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012307:Risk Factors; D013036:Spasms, Infantile / Q000401:mortality; D015996:Survival Rate