Cerebrovascular accidents occuring as a complication of cardiac catheterization: a report of two cases.

Abstract

Cardiac catheterization i s an accepted diagnostic technique with a mortality of less than 0.5% 1 and a correspondingly minor postoperative morbidity. Frequently this procedure is performed on older children and adults on an outpatient basis with only meperidine (Demerol) analgesia and local procaine infiltration anesthesia. One of the well-known potential hazards of congenital heart disease, particularly cyanotic congenital heart disease with secondary polycythemia, is the development of intracranial complications, either brain abscess 2 or spontaneous cerebral arterial thrombosis. 3 Cerebral artery thrombosis is most likely to occur during periods of dehydration or when the hematocrit is so high that the viscosity of the blood is increased appreciably. 4 The occurrence of this complication during the procedure of cardiac catheterization has not been reported. Within a period of two months, two patients, one with severe cyanotic congenital heart disease and another with an acyanotic congenital heart lesion, developed manifestations in the immediate posteatheterization period