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Changing Trends in Pediatric Cardiac Catheterization of Congenital Heart Diseases in the Last three Decades: From a Tertiary Care Center

Laxmi Shetty Hanumanthayya , Balekundri Vijayalakshmi Ishwarappa , Laxmi Shetty Hanumanthayya , Chitra Narasimhan , Raghu Thagachagere Ramegowda , Cholenahally Nanjappa Manjunath

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Journal of Cardiovascular Medicine and Surgery 6(2):p 111-120, April – June 2020. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.6220.4

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Balekundri Vijayalakshmi Ishwarappa, Shetty Laxmi Hanumanthayya, Chitra Narasimhan et al. Changing Trends in Pediatric Cardiac Catheterization of Congenital Heart Diseases in the Last three Decades from a Tertiary Care Center. J Cardiovasc Med Surg 2020;6(2):111–120.
 

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Abstract

Background: Recent advances in the field of nonsurgical, transcatheter interventions in pediatric cardiology, have metamorphosed the management of congenital heart disease. There is a significant change, with adoption of new techniques. Objective: To study the changing pattern of cardiac catheterization in congenital heart diseases over the last 3 decades. Materials and Results: This is a retrospective, single center study of 8,708 cases who underwent cardiac catheterization for various congenital heart diseases between April 1981 to Dec 2015. Age group ranged from 14-hour old neonate to 18 years. The study included 4,754 (54.6%) boys and 3,954 (45.4%) girls. Various clinical details were noted with particular emphasis on indication for catheterization, age, gender and details of interventions. Commonest conditions catheterized were atrial septal defects 2,015 (23.1%), ventricular septal
defects 1,653 (18.9%), patent ductus arteriosus 1,179 (13.5%), Tetralogy of Fallot 1,102 (12.7%), Pulmonary stenosis 882 (10.1%), rest were coarctation of aorta and other complex conditions. Patients were divided into three groups – Group-1(1981-1997), Group-2(1998-2006) and Group-3(2007-2015). Results showed that Group-1 mainly comprised of diagnostic catherisations. Group 2 and 3 showed both diagnostic and therapeutic indications for catheterization and the number of interventional catheterizations increased from 28%(n=652) in Group-2 to 56%(n-1439) in Group-3 (p<0.001) and number of diagnostic catheterization decreased from 98% in Group-1 to 72%(n=1677) in Group-2 to just 44%(n=1150) in Group-3(p < 0.001). Conclusions: There is significant shift from diagnostic s to therapeutic interventions in the last 3 decades. Availability of expertise and infrastructure have been mainly responsible for this trend.

 

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Balekundri Vijayalakshmi Ishwarappa, Shetty Laxmi Hanumanthayya, Chitra Narasimhan et al. Changing Trends in Pediatric Cardiac Catheterization of Congenital Heart Diseases in the Last three Decades from a Tertiary Care Center. J Cardiovasc Med Surg 2020;6(2):111–120.
 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.6220.4

Keywords

Catheterization trends; Congenital heart diseases; Diagnostic catheterizations; Therapeutic interventions.

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