Evaluation of the Outcomes of Cardiac Catheterization in Newborns

Objective: Cardiac catheterization and angiography can be performed for diagnostic or interventional purposes in patients with congenital heart diseases. This study aimed to evaluate the outcomes of cardiac catheterization in neonates as a newly established unit. Material and Methods: Records of neonates (under 28 days), who underwent cardiac catheterization and angiography procedures in our clinic between October 2020 and July 2021, were retrospectively reviewed. The demographic data of patients, echocardiographic diagnosis, cardiac catheterization, and angiography indications, and their outcomes were evaluated.
Results: A total of 76 cardiac catheterization and angiography sessions were performed in 66 neonates (34 males and 32 females), and this number constituted 22% of all angiography procedures performed in our hospital during childhood. Patients’ median age and weight were 9 days (range, 1-28) and 3.1 kg (range, 1.7-4.3), respectively. Of the sessions, 88% (67/76) were performed for interventional purposes and 12% (9/76) for diagnostic. In 67 interventional angiography sessions, 74 interventional procedures were performed. The most common interventional procedures were patent ductus arteriosus stenting (n=47/74, 64%); balloon atrial septostomy (n=16/74, 22%); and pulmonary balloon valvuloplasty (n=5/74, 7%). Among the diagnostic procedures, 5 were for postoperative patient evaluation, wherein 3 patients were on extracorporeal membrane oxygenation (ECMO) support. The median procedure and fluoroscopy time were 37 min (range, 9-137) and 468 s (range, 66-2490), respectively. No complications were observed in 64/76 procedures (84%). Hence, complications were observed in 12/76 (16%) procedures, whereas major complications were observed in 8 and minor in 4 procedures. Two patients needed ECMO support in the catheterization laboratory during the procedure. No case died within the first 24 h. One of the two patients, under ECMO, was successfully discharged.
Conclusion: With the advancement in technological amenities, cardiac catheterization procedures, especially interventional procedures, could be performed with low mortality and high success rates in newborns. Diagnostic catheterizations should be performed for highlighting the underlying problems after cardiac surgery, where other diagnostic tools are insufficient.