title: Outcomes following cardiac catheterization after congenital heart surgery.
abstract: OBJECTIVE
  Describe outcomes following unplanned cardiac catheterization after congenital heart surgery.
  
  
  BACKGROUND
  Utility of cardiac catheterization following congenital heart surgery is relatively understudied.
  
  
  METHODS
  Retrospective study examining demographics, indications, and outcomes of unplanned cardiac catheterization after congenital heart surgery at a single institution.
  
  
  RESULTS
  Between October 2004 and April 2011, 120 patients underwent 150 unplanned postoperative cardiac catheterizations. Median day of catheterization was postoperative day 20 (range 1-269 days). Survival 30 days postcatheterization was 85%; overall survival to hospital discharge was 72%. Indications for catheterization: 63 for hemodynamic evaluation, 46 for likely intervention, and 41 for assessment of surgical repair. Of the 150 hemodynamic/interventional catheterizations, 103 (69%) were associated with a change in clinical management: 59 trans-catheter interventions, 22 re-operations, 11 changes in medication, six changes in surgical plan, and five withdrawals of support. Complications included hemorrhage in two patients, supraventricular tachycardia in two patients, and transient complete heart block requiring cardiopulmonary resuscitation in one patient.
  
  
  CONCLUSIONS
  Cardiac catheterization following congenital heart surgery may enable important diagnostic and therapeutic changes in clinical and surgical management. Complications were rare.
authors.affiliation: Department of Pediatrics, Cardiovascular Institute, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Siehr
authors.forename: Mary Hunt
authors.initials: MH
authors.lastname: Martin
authors.forename: David
authors.initials: D
authors.lastname: Axelrod
authors.forename: Bradley
authors.initials: B
authors.lastname: Efron
authors.forename: Lynn
authors.initials: L
authors.lastname: Peng
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Roth
authors.forename: Stanton
authors.initials: S
authors.lastname: Perry
authors.forename: Andrew Y
authors.initials: AY
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: complications; congenital heart disease; pediatric catheterization/intervention; pediatric intervention; pediatrics