Objective: To examine the types of procedures and analyze the frequency of anesthesia-related complications during pediatric cardiac catheterization. Study Design: A prospective observational study. Place and Duration of Study: Pediatric Cardiac Catheterization Lab at AFIC/NIHD Rawalpindi, from July 2019 to Nov 2019. Methodology: Total 180 consecutive patients undergoing cardiac catheterization fulfilling inclusion criteria were studied. Demographic variables, diseases, type of procedure, variables and anesthesia-related complications were noted. All the data was analyzed using SPSS-23. Results: The study included180 patients where 96 (53.3%) were male and 84 (46.7%) were female. Most of the patients in our study were between ages 1 to 3 years (85). 99 (55.0%) patients had diagnostic cardiac catheterizetion (CC), while 81 (45%) patients underwent interventional procedures. The overall complication rate noted as 18.9%, including arrhythmia in 11.1% followed by hypotension 4.4%, laryngospasm 3.9% and inotropic support requirement 3.3%, Mortality was 0.6%. Most of the patients presenting to the pediatric cardiac catheterization lab were for PDA device closure (16.6%). Age of child was found to be significant risk factor for cardiac catheterizetion associated complications with a p-value of 0.022. Conclusion: Congenital and structural heart disease catheterization procedures are progressively increasing, especially due to the medical advances and complex interventional therapeutic procedures. A thorough preanesthesia assessment should be carried out to optimize before cardiac catheterization.
Objectives: To study the early outcomes of mitral valve replacement with a mechanical prosthesis is patients with rheumatic mitral valvular disease. Study Design: Retrospective Observational study. Setting: Punjab Institute of Cardiology, Lahore and Rawalpindi Institute of Cardiology, Rawalpindi. Period: From August 2014 to August 2017. Material & Methods: Consecutive patients who underwent mitral valve replacement for a rheumatic pathology were included in the study. Patients undergoing a redo surgery, those with concomitant aortic valve intervention, coronary artery bypass grafting and emergency procedures were excluded from the study. Results: Of the 104 patients included in the study, 58 (56.2%) were female patients. The mean age of the patients was 35 ± 12.36 years (median 33 years). Sixty (58.5%) had hypertension and 22 (21.28%) had diabetes. Mitral valve stenosis was the main pathology in 84 (81.25%). Severe pulmonary hypertension was recorded in 15 (15%) patients. The mean preoperative Tricuspid Valve Pressure Gradient (TVPG) was 55.33 ± 18.35 mmHg. The mean cross clamp time was 45.33 ± 12.32 minutes. The postoperative tricuspid valve pressure gradient came down to 31.5 ± 12.21 mmHg. No patients had acute renal injury, pulmonary complications or re-exploration for bleeding. Perioperative mortality was 4 (3.75%). Conclusion: Rheumatic valvular disease is still prevalent in our part of the world. Most of the patients with rheumatic heart disease will end up with replacement of the valve. Replacement with a mechanical prosthesis has favorable early outcomes.
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