Three years of interventional pediatric cardiology experience in a newly built city hospital

Abstract

Aim: The importance of interventional methods in the treatment of congenital heart disease (CHD) is increasing. In this article, we retrospectively evaluated our angiography experience for the diagnosis and treatment of congenital heart diseases in the newly built Kayseri City Hospital for 3 years. Material and Method: The demographic data of the patients, their diagnoses and information about interventions were evaluated retrospectively. Results: In our center, 291 interventional procedures were performed in a 36-month period. 71 (24%) procedures were for diagnostic evaluation and 220 (76%) procedures were for treatment. 74 (25%) atrial septal defect (ASD) closure procedures, 9 (3%) ventricular septal defect (VSD) closure procedures and 62 (21.3%) patent ductus arteriosus (PDA) closure procedures were performed via percutaneous technique. Eleven of the patients who underwent PDA closure were <2500 g infants who hospitalized in the neonatal intensive care unit. Balloon valvuloplasty was performed for 17 (5.8%) pulmonary valvular stenosis and 9 (3%) aortic valvular stenosis. Balloon angioplasty was performed to aortic coarctation in 21 (7.2%) patients and stent angioplasty was performed in 4 (1.3%) patients. As rare procedures, stent angioplasty to ductus arteriosus in 4 (1.3%) patients, pericardiocentesis in 5 (1.7%) patients, and temporary pacemaker implantation in 1 patients were performed. Major complications occurred in 2 procedure for ASD closure, 1 procedure for stent implantation to the ductus arteriosus, and 1 procedure for aortic balloon valvuloplasty (1.3 %). Two patients died due to major complications related to angiographic procedures (0.68%). Conclusion: Treatment of CHD with interventional methods should be preferred instead of surgery if anatomically appropriate, due to the lower rate of major complications, not requiring sternotomy, and shorter hospital stay. More experience is needed in pediatric cardiology teams who are new to these procedures.

Keywords

• Congenital heart diseases
• interventional treatments
• city hospitals

Project Number

48

References

1. Bouma BJ, Mulder BJM. Changing Landscape of Congenital Heart Disease. Circ Res 2017; 120: 908–22.
2. Başpinar O, Karaaslan S, Oran B, Baysal T, Elmaci AM, Yorulmaz A. Prevalence and distribution of children with congenital heart diseases in the central Anatolian region, Turkey. Turk J Pediatr 2006; 48: 237–43.
3. Rashkind WJ. Palliative procedures for transposition of the great arteries’. Br Heart J 1971; 33: 69–72.
4. Jalal Z, Hascoët S, Gronier C, et al. Long-term outcomes after percutaneous closure of ostium secundum atrial septal defect in the young: a nationwide cohort study. JACC Cardiovasc Interv 2018; 11: 795–804.
5. DiBardino DJ, McElhinney DB, Kaza AK, Mayer JE. Analysis of the US Food and Drug Administration Manufacturer and User Facility Device Experience database for adverse events involving Amplatzer septal occluder devices and comparison with the Society of Thoracic Surgery congenital cardiac surgery databas. J Thorac Cardiovasc Surg 2009; 137: 1334–41.
6. Baruteau AE, Hascoët S, Fraisse A. Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children. J Thorac Dis 2017; 9: 1247–56.
7. Chessa M, Carminati M, Butera G, et al. Early and late complications associated with transcatheter occlusion of secundum atrial septal defect. J Am Coll Cardiol 2002; 39: 1061–5.
8. Pass RH, Hijazi Z, Hsu DT, Lewis V, Hellenbrand WE. Multicenter USA amplatzer patent ductus arteriosus occlusion device trial: Initial and one-year results. J Am Coll Cardiol 2004; 44: 513–9.

9. Allen HD, Beekman RH, Garson A, et al. Pediatric therapeutic cardiac catheterization: A statement for healthcare professionals from the council on cardiovascular disease in the young, American Heart Association. Circulation 1998; 97: 609–25.
10. Abu Hazeem AA, Gillespie MJ, Thun H, et al. Percutaneous closure of patent ductus arteriosus in small infants with significant lung disease may offer faster recovery of respiratory function when compared to surgical ligation. Catheter Cardiovasc Interv 2013; 82: 526–33.
11. 1Narin N, Pamukçu Ö, Baykan A, et al. Transcatheter closure of PDA in premature babies less than 2 kg. Anatol J Cardiol 2017; 17: 147–53.
12. Pamukcu O, Narin N, Baykan A, Sunkak S, Tasci O, Uzum K. Mid-term results of percutaneous ventricular septal defect closure with Amplatzer Duct Occluder-II in children. Cardiol Young 2017; 27: 1726–31.
13. Senaidi KS al, Maskary S al, Thomas E, et al. Percutaneous closure of ventricular septal defects in 116 patients: experience with different devices. Sultan Qaboos Univ Med J 2020 20: e352-9.
14. Walavalkar V, Maiya S, Pujar S, et al. Percutaneous device closure of congenital ısolated ventricular septal defects: a single-center retrospective database study amongst 412 cases. Pediatr Cardiol 2020; 41: 591-8.
15. Alizadehasl A, Sadeghpour A. Congenital aortic valve stenosis. Comprehensive Approach to Adult Congenital Heart Disease. London; Springer, 2014: p275–9.
16. Varan B, Yakut K, Erdoğan İ, Özkan M, Tokel K. Aortic balloon valvuloplasty and mid-term results in newborns: a single center experience. Turk J Pediatr 2020; 62: 233–43.
17. Ewert P, Bertram H, Breuer J, et al. Balloon valvuloplasty in the treatment of congenital aortic valve stenosis -- A retrospective multicenter survey of more than 1000 patients. Int J Cardiol 2011; 149: 182–5.
18. El-Saeidi SA, Hamza HS, Agha HM, et al. Experience with balloon pulmonary valvuloplasty and predictors of outcome: A ten-year study. Cardiol Young 2020; 30: 482-8
19. Merino-Ingelmo R, Santos-de Soto J, Coserria-Sánchez F, Descalzo-Señoran A, Valverde-Pérez I. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population. Rev Esp Cardiol (Engl Ed) 2014; 67: 374–9.
20. Torok RD. Coarctation of the aorta: Management from infancy to adulthood. World J Cardiol 2015; 7: 765-75.
21. Cheatham JP. Stenting of coarctation of the aorta. Catheter Cardiovasc Interv 2001; 54: 112–25.
22. Ovaert C, McCrindle BW, Nykanen D, MacDonald C, Freedom RM, Benson LN. Balloon angioplasty of native coarctation: clinical outcomes and predictors of success. J Am Coll Cardiol 2000; 35: 988–96.
23. Boehm W, Emmel M, Sreeram N. Balloon atrial septostomy: history and technique. Images Paediatr Cardiol 2006; 8: 8–14.
24. Holzer RJ, Wood A, Chisolm JL et al. Atrial septal ınterventions in patients with hypoplastic left heart syndrome. Catheter Cardiovasc Interv 2008; 72: 696-704
25. McMullan DM, Permut LC, Jones TK, Johnston TA, Rubio AE. Modified Blalock-Taussig shunt versus ductal stenting for palliation of cardiac lesions with inadequate pulmonary blood flow. J Thorac Cardiovasc Surg 2014; 147: 397–403.
26. Kumar R, Sinha A, Lin MJ et al. Complications of pericardiocentesis: a clinical synopsis. Int J Crit Illn Inj Sci 2015; 5: 206–12.
27. Beardsall K, White DK, Pinto EM. Pericardial effusion and cardiac tamponade as complications of neonatal long lines: are they really a problem? Arch Dis Child Fetal Neonatal Ed 2003; 88: 292-5.
28. Pizzuti A, Parodi E, Abbondi P, Frigerio M. Cardiac tamponade and successful pericardiocentesis in an extremely low birth weight neonate with percutaneously inserted central venous line: a case report. Cases J 2010; 11: 3.
29. Sachdeva S, Gupta SK. Imaging Modalities in Congenital Heart Disease. Indian J Pediatr 2020; 87: 385–97.