Complications of Cardiac Catheterization in Structural Heart Disease
#MMPMID27014356
Lee KE
; Seo YJ
; Kim GB
; An HS
; Song YH
; Kwon BS
; Bae EJ
; Noh CI
Korean Circ J
2016[Mar]; 46
(2
): 246-55
PMID27014356
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BACKGROUND AND OBJECTIVES: Cardiac catheterization is used to diagnose structural
heart disease (SHD) and perform transcatheter treatment. This study aimed to
evaluate complications of cardiac catheterization and the associated risk factors
in a tertiary center over 10 years. SUBJECTS AND METHODS: Total 2071 cardiac
catheterizations performed at the Seoul National University Children's Hospital
from January 2004 to December 2013 were included in this retrospective study.
RESULTS: The overall complication, severe complication, and mortality rates were
16.2%, 1.15%, and 0.19%, respectively. The factors that significantly increased
the risk of overall and severe complications were anticoagulant use before
procedure (odds ratio [OR] 1.83, p=0.012 and OR 6.45, p<0.001, respectively),
prothrombin time (OR 2.30, p<0.001 and OR 5.99, p<0.001, respectively), general
anesthesia use during procedure (OR 1.84, p=0.014 and OR 5.31, p=0.015,
respectively), and total procedure time (OR 1.01, p<0.001 and OR 1.02, p<0.001,
respectively). Low body weight (OR 0.99, p=0.003), severe SHD (OR 1.37, p=0.012),
repetitive procedures (OR 1.7, p=0.009), and total fluoroscopy time (OR 1.01,
p=0.005) significantly increased the overall complication risk. High activated
partial thromboplastin time (OR 1.04, p=0.001), intensive care unit admission
state (OR 14.03, p<0.001), and concomitant electrophysiological study during
procedure (OR 3.41, p=0.016) significantly increased severe complication risk.
CONCLUSION: Currently, the use of cardiac catheterization in SHD is increasing
and becoming more complex; this could cause complications despite the preventive
efforts. Careful patient selection for therapeutic catheterization and improved
technique and management during the peri-procedural period are required to reduce
complications.
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