Transcatheter Cardiac Interventions in Neonates with Congenital Heart Disease: A Single Centre Experience
DOI:
https://doi.org/10.51253/pafmj.v74i3.7158Keywords:
Atria, Echocardiography, Newborn, Transcatheter.Abstract
Objective: To analyze the outcome among neonates undergoing transcatheter balloon atrial septostomy for various kinds of congenital heart diseases.
Study Design: Prospective longitudinal study.
Place and Duration of Study: National Institute of Cardiovascular Diseases, Karachi Pakistan, from Feb 2020 to May 2021.
Methodology: A total of 28 neonates of both genders with echocardiography proven diagnosis of Tricuspid Atresia with restrictive Patent Foramen Ovale, Dextro-Transposition of Great Arteries with Intact Ventricular Septum, complex cyanotic congenital heart disease with inadequate mixing or hypoplastic left heart syndrome with restrictive PFO and a non-significant Patent Ductus Arteriosus, undergoing transcatheter balloon atrial septostomy were included. Demographic data along with diagnosis, clinical presentation, echocardiographic findings, procedural outcome (successful/unsuccessful), duration of the procedure, complication (if any), post-procedural echocardiographic findings, duration of hospital stay, further treatment plan and 3-months follow up outcomes were recorded among all neonates.
Results: Most common diagnosis was Dextro-Transposition of the Great Arteries with IVS observed in 14(50.0%) neonates. Procedural outcome was found to be successful among 23(82.1%) neonates. There were 19(67.9%) neonates who did not show any post-procedure complication. At 3-months follow up, improvement in blood saturation and weight gain were reported among 12(42.9%) neonates each. Overall, mortality was noted in 7(25.0%) neonates, of whom 4(57.1%) neonates were having hypoplastic left heart syndrome.
Conclusion: Transcatheter atrial septostomy done in neonatal period was found to have positive outcomes. Mortality remains high among neonates undergoing transcatheter atrial septostomy having hypoplastic left heart syndrome.
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References
Gundogdu Z, Babaoglu K, Deveci M, Tugral O, Zs U. A Study of Mortality in Cardiac Patients in a Pediatric Intensive Care Unit. Cureus 2019; 11(11): e6052.
https://doi.org/10.7759/cureus.6052
Latal B. Neurodevelopmental outcomes of the child with congenital heart disease. Clin Perinatol 2016; 43: 173-185.
https://doi.org/10.1016/j.clp.2015.11.012
Rizvi SF, Mustafa G, Kundi A, Khan MA. Prevalence of congenital heart disease in rural communities of Pakistan. J Ayub Med Coll Abbottabad. 2015; 27(1): 124-127.
Lawn JE, Cousens S and Zupan J. 4 million neonatal deaths: when? where? why? Lancet
; 365(9462): 891–900.
https://doi.org/10.1016/S0140-6736(05)71048-5
Changlani TD, Jose A, Sudhakar A, Rojal R, Kunjikutty R, Vaidyanathan B. Outcomes of infants with prenatally diagnosed congenital heart disease delivered in a tertiary-care pediatric cardiac facility. Indian Pediatr 2015; 52(10): 852–856.
https://doi.org/10.1007/s13312-015-0731-x
Colaco SM, Karande T, Bobhate PR, Jiyani R, Rao SG, Kulkarni S. Neonates with critical congenital heart defects: Impact of fetal diagnosis on immediate and short-term outcomes. Ann Pediatr Cardiol 2017; 10(2): 126–130.
https://doi.org/10.4103/apc.APC_125_16
Kerneis M, Nafee T, Yee MK, Kazmi HA, Datta S, Zeitouni M, et al. Most Promising Therapies in Interventional Cardiology. Curr Cardiol Rep 2019; 21(4): 26.
https://doi.org/10.1007/s11886-019-1108-x
Krishna MR, Kumar RK. Diagnosis and Management of Critical Congenital Heart Diseases in the Newborn. Indian J Pediatr 2020; 87(5): 365-371. https://doi.org/10.1007/s12098-019-031634
Grigorios T, Stefanos D, Athanasios M, Koniari I, Armylagos S, Davlouros P, et al. Transcatheter versus surgical aortic valve replacement in severe, symptomatic aortic stenosis. J Geriatr Cardiol 2018; 15(1): 76-85.
https://doi.org/10.11909/j.issn.1671-5411.2018.01.002
Larsen SH, Olsen M, Emmertsen K, Hjortdal VE. Interventional Treatment of Patients With Congenital Heart Disease: Nationwide Danish Experience Over 39 Years. J Am Coll Cardiol 2017; 69(22): 2725-2732.
https://doi.org/10.1016/j.jacc.2017.03.587
Melekoglu AN, Baspinar O. Transcatheter cardiac interventions in neonates with congenital heart disease: A single centre experience. J Int Med Res 2019; 47(2): 615-625.
https://doi.org/10.1177/0300060518806111
Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 1998; 32(5): 1433-40.
https://doi.org/10.1016/s0735-1097(98)00396-9
Karagöz T, Akın A, Aykan HH, Çeliker A, Alehan D, Özer S, et al. Interventional cardiac catheterization in infants weighing less than 2500 g. Turk J Pediatr 2015; 57(2): 136-140.
Sachdeva S, Shakya S, Kothari SS. Thrombus in transit after balloon atrial septostomy. Ann Pediatr Cardiol 2020; 13(4): 371-372. https://doi.org/10.4103/apc.APC_172_19
Vlahos AP, Lock JE, McElhinney DB, van der Velde ME. Hypoplastic left heart syndrome with intact or highly restrictive atrial septum: outcome after neonatal transcatheter atrial septostomy. Circulation 2004; 109(19): 2326-2330.
https://doi.org/10.1161/01.CIR.0000128690.35860.C5
Moszura T, Góreczny S, Dryżek P. Hypoplastic left heart syndrome - a review of supportive percutaneous treatment. Postepy Kardiol Interwencyjnej 2014; 10(3): 201-208.
https://doi.org/10.5114/pwki.2014.45148
Holzer RJ, Wood A, Chisolm JL, Hill SL, Phillips A, Galantowicz M, et al. Atrial septal interventions in patients with hypoplastic left heart syndrome. Catheter Cardiovasc Interv 2008; 72(5): 696-704. https://doi.org/10.1002/ccd.21673
Al Maluli H, DeStephan CM, Alvarez RJ Jr, Sandoval J. Atrial Septostomy: A Contemporary Review. Clin Cardiol 2015; 38(6): 395-400. https://doi.org/10.1002/clc.22398
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