Interventional catheterization performed in the early postoperative period after congenital heart surgery in children

Zahn, Evan M.; Dobrolet, Nancy; Nykanen, David; Ojito, Jorge; Hannan, Robert L.; Burke, Redmond P.

doi:10.1016/j.jacc.2003.10.051

Cited by 86 publications

(46 citation statements)

References 12 publications

(15 reference statements)

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“…17, 18 We found that patients who underwent unplanned reintervention within 2 days of the initial surgical procedure had lower hospital mortality than those who underwent reintervention 8 to 18 days after. A similar finding was noted in a study of infants and children who underwent unplanned cardiac catheterization early after cardiac surgery.…”

Section: Discussionmentioning

confidence: 77%

“…A similar finding was noted in a study of infants and children who underwent unplanned cardiac catheterization early after cardiac surgery. 17 It is likely patients undergoing reintervention within 2 days had overt signs of an anatomic problem or circulatory insufficiency that prompted early investigation. The increased mortality in patients undergoing unplanned reintervention between postoperative days 8 and 18 might represent the more difficult spectrum of patients whose clinical trajectory stalls.…”

Section: Discussionmentioning

confidence: 99%

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Unplanned reinterventions are associated with postoperative mortality in neonates with critical congenital heart disease

Mazwi

Brown

Marshall

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Objective Neonates with critical congenital heart disease remain at risk of adverse outcomes after cardiac surgery. Residual or undiagnosed anatomic lesions might be contributory. The present study aimed to describe the incidence and type of cardiac lesions that lead to early, unplanned cardiac reintervention, identify the risk factors for unplanned reintervention, and explore the associations between unplanned reinterventions and hospital mortality. Methods The present single-center retrospective cohort study included 943 consecutive neonates with critical congenital heart disease who underwent cardiac surgery from 2002 to 2008. An unplanned cardiac reintervention was defined as a cardiac reoperation or interventional cardiac catheterization performed during the same hospitalization as the initial operation. Multivariate logistic regression analyses were used to identify the risk factors for unplanned cardiac reintervention and hospital mortality. Results Of the 943 neonates, 104 (11%) underwent an unplanned cardiac reintervention. The independent predictors of unplanned reintervention included prenatal diagnosis, lower birth weight, need for mechanical ventilation before the initial cardiac operation, lower attending surgeon experience, and greater Risk Adjustment in Congenital Heart Surgery, version 1, category. Those who underwent reintervention had increased hospital mortality (n = 33/104, 32%) relative to those who did not (n = 31/839, 4%; adjusted odds ratio, 8.6; 95% confidence interval, 4.7 to 15.6; P < .001). The mortality rates among patients undergoing surgical reintervention (23/66, 35%) or transcatheter reintervention (4/16, 25%), or both (6/22, 27%) were similar (P = .66). Conclusions The need for unplanned cardiac reintervention in neonates with critical congenital heart disease is strongly associated with increased mortality. Early unplanned reinterventions might be an important covariate in outcomes studies and useful as a quality improvement measure.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Unplanned reinterventions are associated with postoperative mortality in neonates with critical congenital heart disease

Mazwi

Brown

Marshall

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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“…Dilation or stenting of fresh suture lines once an occlusion has been traversed can be accomplished reasonably safely with relatively conservative balloon sizes. [2425]…”

Section: Procedural Planning Considerationsmentioning

confidence: 99%

Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease

Latson

Qureshi

2010

Ann Pediatr Card

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Occlusions of major vessels in patients with congenital heart disease may occur due to a variety of factors. These occlusions are often felt to be best addressed surgically; however, we and others have been successful in recanalizing most of these vessels in the catheterization laboratory. Most of these patients will require multiple procedures in the catheterization laboratory to ensure vessel patency and to facilitate vessel growth. Physicians performing the procedure should have a thorough understanding of the anatomic considerations for the intended procedure and have access to a variety of devices and equipment to optimize the result of the procedure. In this article, we review some of the technical aspects that are vital for the success of the procedure.

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“…1 Today, the utility of ECMO as a supportive strategy for high-risk interventional procedures in infants with congenital heart disease is expanding in practice. 2,3 Herein, we present a neonate with hypoplastic left heart syndrome (HLHS) who underwent stenting of the Sano shunt (SS) and left pulmonary artery (LPA) after Norwood Sano procedure using intra-procedural ECMO support.…”

Section: Introductionmentioning

confidence: 99%

Stent Placement in a Neonate with Sano Modification of the Norwood using Semi-Elective Extracorporeal Membrane Oxygenation

Gülgün

Slack²

2016

Arquivos Brasileiros De Cardiologia

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Extracorporeal membrane oxygenation (ECMO) is a well-established tool of cardiopulmonary circulatory support for cardiopulmonary failure in children and adults. It has been used as a supportive strategy during interventional procedures in neonates with congenital heart disease. Herein, we describe a neonate with hypoplastic left heart syndrome who underwent stenting of the Sano shunt and left pulmonary artery after Norwood Sano operation using intra-procedural ECMO support. The use of ECMO as a bridge to recovery might be a feasible and reasonably safe adjunctive approach in the treatment of complications in selective case of neonates having undergone the Norwood Sano procedure.

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Interventional catheterization performed in the early postoperative period after congenital heart surgery in children

Abstract: Transcatheter interventions can be successfully performed in the early postoperative period. These procedures can have a positive impact on patient outcome; however, they should be performed only by a pediatric interventional cardiologist supported by a multi-disciplinary team.

Cited by 86 publications

References 12 publications

Unplanned reinterventions are associated with postoperative mortality in neonates with critical congenital heart disease

Unplanned reinterventions are associated with postoperative mortality in neonates with critical congenital heart disease

Techniques for transcatheter recanalization of completely occluded vessels and pathways in patients with congenital heart disease

Stent Placement in a Neonate with Sano Modification of the Norwood using Semi-Elective Extracorporeal Membrane Oxygenation

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