Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta/Emory University School of Medicine, Atlanta, Georgia.
Division of Cardiothoracic Surgery, Department of Pediatrics, Children's Healthcare of Atlanta/Emory University School of Medicine, Atlanta, Georgia.
JACC Cardiovasc Interv. 2014 Dec;7(12):1437-43. doi: 10.1016/j.jcin.2014.06.022.
This study sought to demonstrate that early cardiac catheterization, whether used solely as a diagnostic modality or for the use of transcatheter interventional techniques, can be used effectively and with an acceptable risk in the post-operative period.
Cardiac catheterization offers important treatment for patients with congenital heart disease. Early post-operative cardiac catheterization is often necessary to diagnose and treat residual anatomic defects. Experience with interventional catheterization to address post-operative concerns is limited.
This was a retrospective cohort study. The medical and catheterization data of pediatric patients who underwent a cardiac catheterization ≤30 days after congenital heart surgery between November 2004 and July 2013 were reviewed. Patients who underwent right heart catheterization and endomyocardial biopsy after heart transplantation were excluded.
A total of 219 catheterizations (91 interventional procedures, 128 noninterventional catheterizations) were performed on 193 patients. Sixty-five interventions (71.43%) were dilations, either balloon angioplasty or stent implantation. There was no difference in survival to hospital discharge between those who underwent an interventional versus noninterventional catheterization (p = 0.93). One-year post-operative survival was comparable between those who underwent an intervention (66%) versus diagnostic (71%) catheterization (p = 0.58). There was no difference in the incidence of major or minor complications between the interventional and diagnostic catheterization cohorts (p = 0.21).
Cardiac catheterization, including transcatheter interventions, can be performed safely in the immediate post-operative period after congenital heart surgery.
本研究旨在证明，心脏导管术无论是作为单纯的诊断手段还是用于经导管介入治疗技术，都可以在术后有效且风险可接受的情况下使用。
心脏导管术为先天性心脏病患者提供了重要的治疗手段。术后早期心脏导管术通常是诊断和治疗残留解剖缺陷所必需的。针对术后问题进行介入导管术治疗的经验有限。
这是一项回顾性队列研究。对 2004 年 11 月至 2013 年 7 月期间接受心脏手术后≤30 天的儿科患者进行心脏导管术的医疗和导管术数据进行了回顾性分析。排除了心脏移植后接受右心导管术和心内膜心肌活检的患者。
193 例患者共进行了 219 次导管术（91 次介入手术，128 次非介入导管术）。65 次干预（71.43%）为扩张术，包括球囊血管成形术或支架植入术。介入组与非介入组患者的住院期间存活率无差异（p=0.93）。行介入组（66%）与诊断组（71%）患者术后 1 年存活率相当（p=0.58）。介入组与诊断组患者的主要或次要并发症发生率无差异（p=0.21）。
心脏导管术，包括经导管介入治疗，可以在先天性心脏病手术后的即刻术后期间安全进行。
