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当代成人及先天性心脏病儿童心脏导管插入术的并发症

Complications of cardiac catheterization in adults and children with congenital heart disease in the current era.

作者信息

Mori Yoshiki, Takahashi Kazuhiro, Nakanishi Toshio

机构信息

Department of Pediatric Cardiology, The Heart Institute, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Heart Vessels. 2013 May;28(3):352-9. doi: 10.1007/s00380-012-0241-x. Epub 2012 Mar 29.

Abstract

The number of adults with congenital heart disease (CHD) requiring diagnostic and/or therapeutic cardiac catheterization has been increasing. However, there have been few studies on the complications of performing cardiac catheterization in adults with CHD. The aim of this study was to determine the incidence of complications during congenital cardiac catheterization in both adults and pediatric patients. A total of 2134 consecutive cardiac catheterizations performed between 2003 and 2008 were prospectively analyzed. Complications were graded from 1 to 5 based on severity and these, with ≥ grade 3 being defined as major. During the study period, 576 procedures (393 diagnostic, 90 interventional, and 93 electrophysiological) were performed in adult patients (≥ 18 years). Complex heart disease was present in 435 of 576 procedures (75.6 %). A total of 65 complications (11.3 %) with 13 major complications including 1 death (2.3 %) were encountered. The most common complications were arrhythmias. The majority of complications were successfully treated or temporary, and all but one of the patients were without residua. Of the 1558 pediatric procedures performed during the same period, we found a total of 229 complications (14.7 %), of which 89 (5.7 %) were major complications including 5 deaths. The safety of performing cardiac catheterization for adult CHD appears to be similar to that for pediatric patients. The complication rates in adults with CHD are low, but not negligible.

摘要

需要进行诊断性和/或治疗性心导管插入术的先天性心脏病(CHD)成年患者数量一直在增加。然而,关于成年CHD患者进行心导管插入术并发症的研究很少。本研究的目的是确定成人和儿科患者先天性心导管插入术期间并发症的发生率。对2003年至2008年间连续进行的2134例心导管插入术进行了前瞻性分析。根据严重程度将并发症分为1至5级,其中≥3级定义为严重并发症。在研究期间,对成年患者(≥18岁)进行了576例手术(393例诊断性手术、90例介入性手术和93例电生理手术)。576例手术中有435例(75.6%)存在复杂心脏病。共出现65例并发症(11.3%),其中13例严重并发症包括1例死亡(2.3%)。最常见的并发症是心律失常。大多数并发症得到了成功治疗或为暂时性,除1例患者外,所有患者均无后遗症。在同一时期进行的1558例儿科手术中,共发现229例并发症(14.7%),其中89例(5.7%)为严重并发症,包括5例死亡。成人CHD患者进行心导管插入术的安全性似乎与儿科患者相似。成年CHD患者的并发症发生率较低,但并非可以忽略不计。

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