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Safety, timing, and outcomes of early post-operative cardiac catheterisation following congenital heart surgery

Published online by Cambridge University Press:  11 April 2024

Karoline Krzywda Open the ORCID record for Karoline Krzywda [Opens in a new window] ,
Jeremy T. Affolter ,
Darcie M. Al-Hassan ,
William J. Gibson ,
Ryan A. Romans Open the ORCID record for Ryan A. Romans [Opens in a new window] ,
Hung-Wen Yeh  and
Kelly S. Tieves Open the ORCID record for Kelly S. Tieves [Opens in a new window]
Karoline Krzywda*
Affiliation:
Division of Critical Care, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
Jeremy T. Affolter
Affiliation:
Department of Pediatrics, University of Texas at Austin, Dell Medical School, Austin, TX, USA Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children’s Medical Center, Austin, TX, USA
Darcie M. Al-Hassan
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
William J. Gibson
Affiliation:
Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
Ryan A. Romans
Affiliation:
Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
Hung-Wen Yeh
Affiliation:
Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA Division of Health Services & Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, USA
Kelly S. Tieves
Affiliation:
Division of Critical Care, Banner Children’s at Desert, Mesa, AZ, USA
*
Corresponding author: Karoline Krzywda; Email: kkrzywda@cmh.edu
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Abstract

Objective:

The safety of early post-operative cardiac catheterisation has been described following congenital heart surgery. Optimal timing of early post-operative cardiac catheterisation remains uncertain. The aim of this study was to describe the safety of early post-operative cardiac catheterisation and its impact on cardiac ICU and hospital length of stay, duration of mechanical ventilation, and extracorporeal support.

Methods:

This single-centre retrospective cohort study compared clinical and outcome variables between “early” early post-operative cardiac catheterisation (less than 72 hours after surgery) and “late” early post-operative cardiac catheterisation (greater than 72 hours after surgery) groups using Chi-squared, Student’s t, and log-rank test (or appropriate nonparametric test).

Results:

In total, 132 patients were included, 22 (16.7%) “early” early post-operative cardiac catheterisation, and 110 (83.3%) “late” early post-operative cardiac catheterisation. Interventions were performed in 63 patients (51.5%), 7 (11.1%) early and 56 (88.9%) late. Complications of catheterisation occurred in seven (5.3%) patients, two early and five late. There were no major complications. Patients in the late group trended towards a longer stay in the cardiac ICU (19 days [7, 62] versus 11.5 days [7.2, 31.5], p = 0.6) and in the hospital (26 days [9.2, 68] versus 19 days [13.2, 41.8], p = 0.8) compared to the earlier group.

Conclusion:

“Early” early post-operative cardiac catheterisation was associated with an overall low rate of complications. Earlier catheterisations trended towards shorter cardiac ICU and hospital length of stays. Earlier catheterisations may lead to earlier recovery for patients not following an expected post-operative course.

Keywords

CHDearly post-operative cardiac catheterisationextracorporeal membrane oxygenation
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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