ABSTRACT
OBJECTIVE: To assess the effectiveness and safety of paediatric interventional cardiac catheterization during the development of the service. SETTING: Sub-regional Paediatric Cardiothoracic Centre. PATIENTS AND METHODS: All paediatric admissions for cardiac catheterisation between January, 1985 and December, 1992. Data were collected on all patients in whom interventional cardiac catheterisation was performed excluding babies undergoing balloon atrial septostomy. Results were compared with those reported previously by the larger centres. RESULTS: One hundred and seventy eight interventional procedures were performed in 158 patients, progressing from pulmonary valvuloplasty (1985) and aortic valvuloplasty (1986) to arterial duct occlusion and coil embolisation of shunts (1991). During the study period there was a rise in the number and variety of conditions for which interventional cardiac catheterisation was performed. In terms of morbidity, mortality and technical success, results compared favourably with those published from larger centres. CONCLUSIONS: Interventional cardiac catheterisation in children can be established effectively and safely in a relatively smaller set up.
Subject(s)
Angioplasty, Balloon , Aortic Valve , Cardiac Catheterization , Pulmonary Valve , Adolescent , Cardiac Care Facilities , Child , Child, Preschool , Heart Valve Diseases/therapy , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Treatment OutcomeABSTRACT
The aim of this study was to examine the pattern of referrals the number of admissions, cardiac catheterisations and surgical procedures-including outcome-in infants and children referred to a sub-regional cardiothoracic unit during a 6-year period. The unit is served by one paediatric cardiologist and four general cardiothoracic surgeons, two of whom undertake paediatric surgery. Referrals were received from within the Trent Regional Health Authority, and from three other health Regions. During the study period 2,097 infants and children were admitted to the unit with cardiac disease, and 730 underwent cardiac surgery. The proportion of admissions undergoing surgery increased significantly with time, as did the neonatal and infant surgical procedures and infant surgical procedures. Overall, the surgical mortality did not alter with time, and was comparable to the national average. The results show an increase in the demand for cardiac investigations and surgery, and this was most evident in infants, particularly for open procedures. This unit serves a large population with proven needs, and the number of children treated falls within the range of existing supra-regional centres. The combination of available expertise, and a cost-effective patient outcome measure, should place such units in a category of high priority for resource allocation.
