Outcome of Interventional Cardiac Catheterization in Newborns Weighing Less Than 2,000 Grams

Objectives: Interventional cardiac catheterization (CC) has become a successful treatment for critical congenital heart defects in newborns. The objective of this study was to describe the outcome of interventional CC in newborns weighing less than 2,000 g.

Methods: This is a retrospective cohort study.

Result: Between January 2001 and June 2020, 29 patients (13 females) were identified with critical congenital heart disease (CHD) requiring interventional CC. The median body weight was 1,600 g (minimum, 800 g; maximum, 1,970 g). Successful intervention was performed in 25 patients. In 10 patients, intervention led to sufficient relief of stenosis, with no further therapy needed (2mon-17a, observation period, nine pulmonary artery stenosis, and one aortic coarctation). In 11 patients, interventional therapy allowed weight gain, and planned surgical treatment could be performed after 2 to 24 months (aortic valve stenosis, HLHS, aortic coarctation, and complex CHD). There were no deaths related to CC, although eight patients died 2 to 14 months after intervention for different cardiac and noncardiac reasons. Complications included temporary (two) and permanent (one) occlusion of the femoral vessel, incomplete lesion of the peroneal nerve (one), rupture of the iliac artery requiring implantation of a covered stent (one), transient complete AV block (one), and CPR during intubation before intervention (two).

Conclusion: Interventional CC is feasible in LBW newborns, either curative or as bridging to surgery when standard surgical options are lacking. Vascular lesions at the puncture site represent the most common complication. Depending on the underlying disease, good long-term results can be archived. Death occurred mostly due to complications associated to immaturity or in patients with syndromes affecting multiple organs.

Publication History

Article published online:
21 February 2021