Interventional cardiac catheterization in neonatal age: results in a multicentre Italian experience

Despite recent technical advances, interventional cardiac catheterization is still challenging in neonatal age and no specific data concerning early outcome are so far published in literature. Neonatal trans-catheter cardiac interventions performed in high-volume Italian referral centers were retros...

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Veröffentlicht in:International journal of cardiology 2020-09, Vol.314, p.36-42
Hauptverfasser: Giordano, Mario, Santoro, Giuseppe, Agnoletti, Gabriella, Carminati, Mario, Donti, Andrea, Guccione, Paolo, Marasini, Maurizio, Milanesi, Ornella, Russo, Maria Giovanna, Castaldi, Biagio, Cheli, Martino, Formigari, Roberto, Gaio, Gianpiero, Giugno, Luca, Lunardini, Alessia, Pepino, Carlotta, Spadoni, Isabella
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container_title International journal of cardiology
container_volume 314
creator Giordano, Mario
Santoro, Giuseppe
Agnoletti, Gabriella
Carminati, Mario
Donti, Andrea
Guccione, Paolo
Marasini, Maurizio
Milanesi, Ornella
Russo, Maria Giovanna
Castaldi, Biagio
Cheli, Martino
Formigari, Roberto
Gaio, Gianpiero
Giugno, Luca
Lunardini, Alessia
Pepino, Carlotta
Spadoni, Isabella
description Despite recent technical advances, interventional cardiac catheterization is still challenging in neonatal age and no specific data concerning early outcome are so far published in literature. Neonatal trans-catheter cardiac interventions performed in high-volume Italian referral centers were retrospectively analyzed. Primary outcomes were procedural major adverse events, in-hospital mortality and procedural failure. Secondary outcomes were minor adverse events and need for blood transfusion. From January 2000 to December 2017, 1423 newborns (mean weight 3.0 ± 0.6 kg, range 1.0–5.8; median age 2.0 days) underwent interventional cardiac catheterization. Overall, global procedure adverse event rate and in-hospital mortality were 10.2% and 5.2%, respectively. At multi-variable analysis, primary composite outcome was significantly related to low-weight (
doi_str_mv 10.1016/j.ijcard.2020.04.013
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Neonatal trans-catheter cardiac interventions performed in high-volume Italian referral centers were retrospectively analyzed. Primary outcomes were procedural major adverse events, in-hospital mortality and procedural failure. Secondary outcomes were minor adverse events and need for blood transfusion. From January 2000 to December 2017, 1423 newborns (mean weight 3.0 ± 0.6 kg, range 1.0–5.8; median age 2.0 days) underwent interventional cardiac catheterization. Overall, global procedure adverse event rate and in-hospital mortality were 10.2% and 5.2%, respectively. At multi-variable analysis, primary composite outcome was significantly related to low-weight (<2.5 kg) (p < 0.01) and younger age (≤7 days) (p < 0.01) at the procedure, prematurity (p < 0.01), uni-ventricular physiology (p < 0.01), associated genetic syndromes (p < 0.01) and procedure risk category (p < 0.01). No relationship between volume of activity of any single center and procedure outcome was found. Over time, a trend toward an increased number of procedures and their complexity was recorded. Trans-catheter management of cardiac malformations with critical, duct-dependent pulmonary blood flow by arterial duct stenting or right ventricular outflow tract stenting showed the highest increase. Interventional cardiac catheterization is relatively safe and feasible in neonatal age. Peri-natal age, low weight, uni-ventricular physiology and genetic syndromes still significantly contribute to procedural morbidity and in-hospital mortality of this approach. •Interventional catheterization in newborns is an effective and safe approach.•Major adverse events rate is influenced by the complexity of the procedure.•Mortality depends on the clinical and hemodynamic characteristics of newborn.•Over time, an increase in number and complexity of procedures was recorded.]]></description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2020.04.013</identifier><identifier>PMID: 32303417</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cardiac Catheterization - adverse effects ; Child, Preschool ; Complications ; Heart Defects, Congenital - diagnostic imaging ; Heart Defects, Congenital - surgery ; Humans ; Infant, Newborn ; Interventional cardiac catheterization ; Italy - epidemiology ; Mortality ; Neonate ; Retrospective Studies ; Treatment Outcome</subject><ispartof>International journal of cardiology, 2020-09, Vol.314, p.36-42</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. 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Peri-natal age, low weight, uni-ventricular physiology and genetic syndromes still significantly contribute to procedural morbidity and in-hospital mortality of this approach. •Interventional catheterization in newborns is an effective and safe approach.•Major adverse events rate is influenced by the complexity of the procedure.•Mortality depends on the clinical and hemodynamic characteristics of newborn.•Over time, an increase in number and complexity of procedures was recorded.]]></description><subject>Cardiac Catheterization - adverse effects</subject><subject>Child, Preschool</subject><subject>Complications</subject><subject>Heart Defects, Congenital - diagnostic imaging</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Interventional cardiac catheterization</subject><subject>Italy - epidemiology</subject><subject>Mortality</subject><subject>Neonate</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPwzAQhC0EoqXwDxDKkUuCX0kaDkio4lGpEhc4W35swFWaFjupgF_PhhaOnNbSfDO7HkLOGc0YZcXVMvNLq4PLOOU0ozKjTByQMZuWMmVlLg_JGLEyzXkpRuQkxiWlVFbV9JiMBBdUSFaOiZ23HYQttJ1ft7pJhkSvLc7uDVDxX3pQEt8mLSDRIaNf4ToJEPumi4OgkxU-vcWQAMkcEa_bBD42aIfWwik5qnUT4Ww_J-Tl_u559pgunh7ms9tFakXBu5TnlFWcl4wCs8wYA0IKl0tHbSGdqbmeMnCiqmnNTC0qhqLJjXF1IcraWTEhl7vcTVi_9xA7tfLRQtNoPL2PiqOnKgvJc0TlDrVhHWOAWm2CX-nwqRhVQ71qqXb1qqFeRaXCetF2sd_QmxW4P9Nvnwjc7ADAf249BBXtTwfOB7Cdcmv__4Zvf0aPVw</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Giordano, Mario</creator><creator>Santoro, Giuseppe</creator><creator>Agnoletti, Gabriella</creator><creator>Carminati, Mario</creator><creator>Donti, Andrea</creator><creator>Guccione, Paolo</creator><creator>Marasini, Maurizio</creator><creator>Milanesi, Ornella</creator><creator>Russo, Maria Giovanna</creator><creator>Castaldi, Biagio</creator><creator>Cheli, Martino</creator><creator>Formigari, Roberto</creator><creator>Gaio, Gianpiero</creator><creator>Giugno, Luca</creator><creator>Lunardini, Alessia</creator><creator>Pepino, Carlotta</creator><creator>Spadoni, Isabella</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200901</creationdate><title>Interventional cardiac catheterization in neonatal age: results in a multicentre Italian experience</title><author>Giordano, Mario ; 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Neonatal trans-catheter cardiac interventions performed in high-volume Italian referral centers were retrospectively analyzed. Primary outcomes were procedural major adverse events, in-hospital mortality and procedural failure. Secondary outcomes were minor adverse events and need for blood transfusion. From January 2000 to December 2017, 1423 newborns (mean weight 3.0 ± 0.6 kg, range 1.0–5.8; median age 2.0 days) underwent interventional cardiac catheterization. Overall, global procedure adverse event rate and in-hospital mortality were 10.2% and 5.2%, respectively. At multi-variable analysis, primary composite outcome was significantly related to low-weight (<2.5 kg) (p < 0.01) and younger age (≤7 days) (p < 0.01) at the procedure, prematurity (p < 0.01), uni-ventricular physiology (p < 0.01), associated genetic syndromes (p < 0.01) and procedure risk category (p < 0.01). No relationship between volume of activity of any single center and procedure outcome was found. Over time, a trend toward an increased number of procedures and their complexity was recorded. Trans-catheter management of cardiac malformations with critical, duct-dependent pulmonary blood flow by arterial duct stenting or right ventricular outflow tract stenting showed the highest increase. Interventional cardiac catheterization is relatively safe and feasible in neonatal age. Peri-natal age, low weight, uni-ventricular physiology and genetic syndromes still significantly contribute to procedural morbidity and in-hospital mortality of this approach. •Interventional catheterization in newborns is an effective and safe approach.•Major adverse events rate is influenced by the complexity of the procedure.•Mortality depends on the clinical and hemodynamic characteristics of newborn.•Over time, an increase in number and complexity of procedures was recorded.]]></abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>32303417</pmid><doi>10.1016/j.ijcard.2020.04.013</doi><tpages>7</tpages></addata></record>
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subjects Cardiac Catheterization - adverse effects
Child, Preschool
Complications
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Humans
Infant, Newborn
Interventional cardiac catheterization
Italy - epidemiology
Mortality
Neonate
Retrospective Studies
Treatment Outcome
title Interventional cardiac catheterization in neonatal age: results in a multicentre Italian experience
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