Caring for the Adult with Congenital Heart Disease in an Adult Catheterization Laboratory by Pediatric Interventionalists-Safety and Efficacy

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Abstract

Objective: The purpose of this study is to describe the outcomes of cardiac catheterizations performed by pediatric interventional cardiologists in an adult catheterization laboratory on adult patients with congenital heart disease (CHD). Background: With improved survival rates, the number of adults with CHD increases by ∼5%/year; this population often requires cardiac catheterization. Methods: From January 2005 to December 2009, two groups of patients were identified, an adult group (>21 years) and an adolescent group (13-21 years), who had catheterizations performed by pediatric interventional staff. Results: Fifty-seven catheterizations were performed in 53 adults, while 59 were performed in 47 adolescents. The male to female ratio differed significantly between groups; only 15/53 (28%) of adults were male vs. 26/47 (55%) of adolescents (P =.006). Among adults, 27 had previously corrected CHD, 16 with atrial septal defect (ASD), and six with patent foramen ovale (PFO). This differed significantly from the adolescents, where only 30 had previously corrected CHD, seven with ASD, and one with PFO (P =.012). Among adults who were catheterized, interventions were performed on 28/53 (53%). All interventions were successful and included ASD/PFO closure, patent ductus arteriosus occlusion, coarctation dilation, pulmonary artery dilations, and one saphenous vein graft aneurysm closure. Nineteen adults had coronary angiography performed by adult interventionalists in consult with pediatric interventionalists. Two complications occurred among adults (3.8%) vs. one complication (2%; P = 1) among adolescents. No femoral vessel complications or catheterization-associated mortality occurred. Conclusions: Cardiac catheterizations can be performed effectively and safely in adults with CHD by pediatric interventional cardiologists in an adult catheterization laboratory.

Original languageEnglish (US)
Pages (from-to)111-116
Number of pages6
JournalCongenital Heart Disease
Volume8
Issue number2
DOIs
StatePublished - Mar 2013

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Catheterization
Heart Diseases
Patent Foramen Ovale
Atrial Heart Septal Defects
Pediatrics
Safety
Cardiac Catheterization
Dilatation
Patent Ductus Arteriosus
Saphenous Vein
Thigh
Coronary Angiography
Pulmonary Artery
Aneurysm
Survival Rate
Transplants
Mortality
Population
Cardiologists

Keywords

  • Complications Adult Catheterization/Intervention
  • Congenital Heart Disease in Adults
  • Diagnostic Cardiac Catheterization
  • Hemodynamics
  • Pediatric Cardiac Catheterization/Intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging

Cite this

@article{ac9fddc175fe4e61abf75e895ab17a7f,
title = "Caring for the Adult with Congenital Heart Disease in an Adult Catheterization Laboratory by Pediatric Interventionalists-Safety and Efficacy",
abstract = "Objective: The purpose of this study is to describe the outcomes of cardiac catheterizations performed by pediatric interventional cardiologists in an adult catheterization laboratory on adult patients with congenital heart disease (CHD). Background: With improved survival rates, the number of adults with CHD increases by ∼5{\%}/year; this population often requires cardiac catheterization. Methods: From January 2005 to December 2009, two groups of patients were identified, an adult group (>21 years) and an adolescent group (13-21 years), who had catheterizations performed by pediatric interventional staff. Results: Fifty-seven catheterizations were performed in 53 adults, while 59 were performed in 47 adolescents. The male to female ratio differed significantly between groups; only 15/53 (28{\%}) of adults were male vs. 26/47 (55{\%}) of adolescents (P =.006). Among adults, 27 had previously corrected CHD, 16 with atrial septal defect (ASD), and six with patent foramen ovale (PFO). This differed significantly from the adolescents, where only 30 had previously corrected CHD, seven with ASD, and one with PFO (P =.012). Among adults who were catheterized, interventions were performed on 28/53 (53{\%}). All interventions were successful and included ASD/PFO closure, patent ductus arteriosus occlusion, coarctation dilation, pulmonary artery dilations, and one saphenous vein graft aneurysm closure. Nineteen adults had coronary angiography performed by adult interventionalists in consult with pediatric interventionalists. Two complications occurred among adults (3.8{\%}) vs. one complication (2{\%}; P = 1) among adolescents. No femoral vessel complications or catheterization-associated mortality occurred. Conclusions: Cardiac catheterizations can be performed effectively and safely in adults with CHD by pediatric interventional cardiologists in an adult catheterization laboratory.",
keywords = "Complications Adult Catheterization/Intervention, Congenital Heart Disease in Adults, Diagnostic Cardiac Catheterization, Hemodynamics, Pediatric Cardiac Catheterization/Intervention",
author = "Sutton, {Nicole J.} and Greenberg, {Mark A.} and Menegus, {Mark A.} and George Lui and Pass, {Robert H.}",
year = "2013",
month = "3",
doi = "10.1111/chd.12004",
language = "English (US)",
volume = "8",
pages = "111--116",
journal = "Congenital Heart Disease",
issn = "1747-079X",
publisher = "Wiley-Blackwell",
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T1 - Caring for the Adult with Congenital Heart Disease in an Adult Catheterization Laboratory by Pediatric Interventionalists-Safety and Efficacy

AU - Sutton, Nicole J.

AU - Greenberg, Mark A.

AU - Menegus, Mark A.

AU - Lui, George

AU - Pass, Robert H.

PY - 2013/3

Y1 - 2013/3

N2 - Objective: The purpose of this study is to describe the outcomes of cardiac catheterizations performed by pediatric interventional cardiologists in an adult catheterization laboratory on adult patients with congenital heart disease (CHD). Background: With improved survival rates, the number of adults with CHD increases by ∼5%/year; this population often requires cardiac catheterization. Methods: From January 2005 to December 2009, two groups of patients were identified, an adult group (>21 years) and an adolescent group (13-21 years), who had catheterizations performed by pediatric interventional staff. Results: Fifty-seven catheterizations were performed in 53 adults, while 59 were performed in 47 adolescents. The male to female ratio differed significantly between groups; only 15/53 (28%) of adults were male vs. 26/47 (55%) of adolescents (P =.006). Among adults, 27 had previously corrected CHD, 16 with atrial septal defect (ASD), and six with patent foramen ovale (PFO). This differed significantly from the adolescents, where only 30 had previously corrected CHD, seven with ASD, and one with PFO (P =.012). Among adults who were catheterized, interventions were performed on 28/53 (53%). All interventions were successful and included ASD/PFO closure, patent ductus arteriosus occlusion, coarctation dilation, pulmonary artery dilations, and one saphenous vein graft aneurysm closure. Nineteen adults had coronary angiography performed by adult interventionalists in consult with pediatric interventionalists. Two complications occurred among adults (3.8%) vs. one complication (2%; P = 1) among adolescents. No femoral vessel complications or catheterization-associated mortality occurred. Conclusions: Cardiac catheterizations can be performed effectively and safely in adults with CHD by pediatric interventional cardiologists in an adult catheterization laboratory.

AB - Objective: The purpose of this study is to describe the outcomes of cardiac catheterizations performed by pediatric interventional cardiologists in an adult catheterization laboratory on adult patients with congenital heart disease (CHD). Background: With improved survival rates, the number of adults with CHD increases by ∼5%/year; this population often requires cardiac catheterization. Methods: From January 2005 to December 2009, two groups of patients were identified, an adult group (>21 years) and an adolescent group (13-21 years), who had catheterizations performed by pediatric interventional staff. Results: Fifty-seven catheterizations were performed in 53 adults, while 59 were performed in 47 adolescents. The male to female ratio differed significantly between groups; only 15/53 (28%) of adults were male vs. 26/47 (55%) of adolescents (P =.006). Among adults, 27 had previously corrected CHD, 16 with atrial septal defect (ASD), and six with patent foramen ovale (PFO). This differed significantly from the adolescents, where only 30 had previously corrected CHD, seven with ASD, and one with PFO (P =.012). Among adults who were catheterized, interventions were performed on 28/53 (53%). All interventions were successful and included ASD/PFO closure, patent ductus arteriosus occlusion, coarctation dilation, pulmonary artery dilations, and one saphenous vein graft aneurysm closure. Nineteen adults had coronary angiography performed by adult interventionalists in consult with pediatric interventionalists. Two complications occurred among adults (3.8%) vs. one complication (2%; P = 1) among adolescents. No femoral vessel complications or catheterization-associated mortality occurred. Conclusions: Cardiac catheterizations can be performed effectively and safely in adults with CHD by pediatric interventional cardiologists in an adult catheterization laboratory.

KW - Complications Adult Catheterization/Intervention

KW - Congenital Heart Disease in Adults

KW - Diagnostic Cardiac Catheterization

KW - Hemodynamics

KW - Pediatric Cardiac Catheterization/Intervention

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U2 - 10.1111/chd.12004

DO - 10.1111/chd.12004

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JO - Congenital Heart Disease

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SN - 1747-079X

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