Abstract
Background: Cardiac catheterization (CC) has been utilized with caution in children on extracorporeal membrane oxygenation (ECMO) due to concerns related to anticoagulation, however there have been no reports of procedure outcome in the literature. This retrospective review was performed to evaluate the indications and outcome of cardiac catheterization (CC) in this population. Methods: We reviewed the catheterization records, hospital charts, and follow up records of all children who have undergone this procedure at our institution from 12/90 to 12/95 (n=14). Records were reviewed to assess indications, results, and complications of CC, as well as clinical outcome. Results: Patients ranged in age from 3 days to 46 months, and diagnoses included single ventricle variants (7), tetralogy of Fallot or variant (4), and others (3). ECMO was utilized preoperatively in 2 pts, and postoperatively in 12 pts; indications for ECMO included low cardiac output or ventricular dysfunction (7), severe hypoxemia (4), and pulmonary hypertension (3). Indications for CC were diagnostic in 12 pts (coronary anatomy, pulmonary artery anatomy, pulmonary vein obstruction, pulmonary hypertension, and/or ventricular function), and interventional in 2 pts (balloon atrial septostomy and aortopulmonary collateral (APC) coil embolization). Two unplanned therapeutic procedures were also performed (coil embolization of APC in 1 pt and of a vertical vein in 1 pt). Adequate evaluation of clinical questions was accomplished in all pts. Unexpected diagnostic information of clinical importance was obtained in 5 pts, including right coronary artery obstruction, significant APC, a vertical vein from a pulmonary venous confluence, left pulmonary artery obstruction, and a restrictive ventricular septal defect causing subaortic obstruction.
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