Korean Circ J.  2016 Mar;46(2):246-255. 10.4070/kcj.2016.46.2.246.

Complications of Cardiac Catheterization in Structural Heart Disease

• Lee KE
• Seo YJ
• Kim GB
• An HS
• Song YH
• Kwon BS
• Bae EJ
• Noh CI

• KMID: 2344477
• DOI: http://doi.org/10.4070/kcj.2016.46.2.246

Abstract

BACKGROUND AND OBJECTIVES
Cardiac catheterization is used to diagnose structural heart disease (SHD) and perform transcatheter treatment. This study aimed to evaluate complications of cardiac catheterization and the associated risk factors in a tertiary center over 10 years.
SUBJECTS AND METHODS
Total 2071 cardiac catheterizations performed at the Seoul National University Children's Hospital from January 2004 to December 2013 were included in this retrospective study.
RESULTS
The overall complication, severe complication, and mortality rates were 16.2%, 1.15%, and 0.19%, respectively. The factors that significantly increased the risk of overall and severe complications were anticoagulant use before procedure (odds ratio [OR] 1.83, p=0.012 and OR 6.45, p<0.001, respectively), prothrombin time (OR 2.30, p<0.001 and OR 5.99, p<0.001, respectively), general anesthesia use during procedure (OR 1.84, p=0.014 and OR 5.31, p=0.015, respectively), and total procedure time (OR 1.01, p<0.001 and OR 1.02, p<0.001, respectively). Low body weight (OR 0.99, p=0.003), severe SHD (OR 1.37, p=0.012), repetitive procedures (OR 1.7, p=0.009), and total fluoroscopy time (OR 1.01, p=0.005) significantly increased the overall complication risk. High activated partial thromboplastin time (OR 1.04, p=0.001), intensive care unit admission state (OR 14.03, p<0.001), and concomitant electrophysiological study during procedure (OR 3.41, p=0.016) significantly increased severe complication risk.
CONCLUSION
Currently, the use of cardiac catheterization in SHD is increasing and becoming more complex; this could cause complications despite the preventive efforts. Careful patient selection for therapeutic catheterization and improved technique and management during the peri-procedural period are required to reduce complications.

Keyword

Catheterization; Complications; Risk factors; Heart diseases; Catheters

MeSH Terms

Anesthesia, General
Body Weight
Cardiac Catheterization*
Cardiac Catheters*
Catheterization
Catheters
Fluoroscopy
Heart Diseases*
Heart*
Intensive Care Units
Mortality
Partial Thromboplastin Time
Patient Selection
Prothrombin Time
Retrospective Studies
Risk Factors
Seoul

Figure

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  Fig. 1 Age distribution of complications. Severe complications mainly occurred before 3 years of age or after 10 years of age, with the highest frequency in patients younger than 1 year of age.

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  Fig. 2 Complication percentage per study year. There was no significant difference in the occurrence of complications according to the year of procedure.

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