title: Cardiac catheterisation in infants weighing less than 2500 grams.
abstract: OBJECTIVE
  To investigate the indications for, and outcome of, cardiac catheterisation in infants weighing less than 2500 g at a single institution over an 8-year period.
  
  
  METHODS
  We assessed all infants who were less than 2500 g at the time of cardiac catheterisation at Texas Children's Hospital from January 1993 to January 2001. Comparisons of morbidity and mortality were drawn with an equivalent number of infants of similar age weighing greater than 2500 g seen over the same period of time.
  
  
  RESULTS
  We performed interventional procedures in 22, and diagnostic catheterisations in 12 infants weighing less than 2500 g. Interventions included pulmonary valvoplasty in six patients, balloon angioplasty of critical coarctation in one, aortic valvoplasty in two, septostomy in ten, and coil occlusion of an arteriovenous malformation, redirection of a subclavian venous line, and coil occlusion of a patent arterial duct in one patient each. The median age at catheterisation was 5 days for children less than 2500 g, and 10 days for those above 2500 g. The median weights were 2.3 kg and 3.3 kg, and the median gestational ages were 35 weeks and 38 weeks, for the two respective groups. Of those weighing less than 2500 g, two died (6%), with no deaths occurring in those weighing more than 2500 g. In 3 patients weighing less than 2500 g (9%), there was vascular compromise, one child with bilateral femoral venous obstruction requiring fasciotomy compared, to one in the group weighing greater than 2500 g (2%).
  
  
  CONCLUSIONS
  There is a significantly increased risk of mortality and vascular compromise in infants weighing less than 2500 g. Interventional catheterisation in these infants may be lifesaving, but given the aforementioned risks, diagnostic catheterisation should be deferred if possible in favor of noninvasive modalities.
authors.affiliation: Lille Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas 77030, USA. cmcmahon@bcm.tmc.edu
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McMahon
authors.forename: Jack F
authors.initials: JF
authors.lastname: Price
authors.forename: Jack C
authors.initials: JC
authors.lastname: Salerno
authors.forename: Howaida
authors.initials: H
authors.lastname: El-Said
authors.forename: Michael
authors.initials: M
authors.lastname: Taylor
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Vargo
authors.forename: Michael R
authors.initials: MR
authors.lastname: Nihill
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D012189:Retrospective Studies; D013781:Texas; D016896:Treatment Outcome