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Safety of outpatient cardiac catheterisation in infants with single-ventricle or shunt-dependent biventricular congenital heart disease

Published online by Cambridge University Press:  12 October 2018

Jamie N. Colombo ,
Michael C. Spaeder  and
Michael R. Hainstock
Jamie N. Colombo*
Affiliation:
Department of Pediatrics, Division of PediatricCardiology, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
Michael C. Spaeder
Affiliation:
Division of Pediatric Critical Care, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
Michael R. Hainstock
Affiliation:
Division of Pediatric Cardiology, University of Virginia Children’s Hospital, University of Virginia, Charlottesville, VA, USA
*
Author for correspondence: Jamie N. Colombo, DO, 1501 N. Campbell Ave., PO Box 245073, Tucson, AZ 85724, USA. Tel: 520-626-5585; Fax: 520-626-6571; E-mail: jamiecolombo@peds.arizona.edu
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Abstract

Objective

We aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation.

Background

Cardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres. Outpatient catheterisation reduces parental anxiety and decreases cost. Our institutional strategy is to discharge patients following a 4- to 6-hour post-procedure observation period.

Methods

Retrospective cohort study using the Society of Thoracic Surgeons Database identified patients <1 year of age with pre-stage II single-ventricle CHD or shunt-dependent biventricular CHD who underwent cardiac catheterisation between 2007 and 2015. Readmission was defined as admission to the hospital within 48 hours after discharge after catheterisation.

Results

A total of 92 patients were included in the analysis. Among them, 62 patients (67%) were discharged after a 4- to 6-hour observation period with only 3% readmission, 18 patients (20%) stayed for a 23-hour observation period, and 12 patients (13%) were admitted for >23 hours. There were no differences in baseline characteristics between discharged and admitted patients. Patients who underwent intervention were more likely to be admitted. Patients with hypoplastic left heart syndrome did not have major adverse events or readmissions. No intra- or peri-procedural deaths occurred.

Conclusions

Outpatient cardiac catheterisation may be a safe option for infants with single-ventricle and shunt-dependent biventricular CHD, with low readmission rates and minimal morbidity.

Keywords

CHDsingle ventriclehypoplastic left heart syndromecardiac catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 12 , December 2018 , pp. 1444 - 1451
Copyright
© Cambridge University Press 2018 

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