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Cardiac Catheterization in Pediatric Patients Supported by Extracorporeal Membrane Oxygenation: A 15-Year Experience

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Abstract

Cardiac catheterization is commonly performed in patients being supported by extracorporeal membrane oxygenation (ECMO). We aimed to evaluate the safety, benefit, and outcomes of catheterization in pediatric patients supported by ECMO. Retrospective review of cardiac catheterizations performed in patients ≤18 years of age while on ECMO at a large tertiary care center between January 2000 and May 2015. A total of 55 catheterizations were performed on 51 patients during 53 unique ECMO courses. Indications for ECMO include ventricular dysfunction (22), cardiac arrest (20), inability to wean from cardiopulmonary bypass (7), and persistent cyanosis (4). Catheterizations included purely diagnostic studies (11), atrial septostomies (34), stenting of vessels or surgical shunts (6), adjustment of a stent (1), coil embolization (1), and endomyocardial biopsy (1). Septostomy was elective in 58.8% of cases (20) and emergent in 41.2% (14). Forty-six catheterizations had either surgical or catheter intervention during the same or subsequent study (83.6%). High severity complications occurred in three patients (5.6%), including one death due to hemothorax after pulmonary artery stent placement. There were no complications during patient transport. In total, 38 out of 53 (71.7%) ECMO courses resulted in decannulation, 29 (54.7%) patients survived to discharge from the hospital, and 25 (47.2%) were alive at follow-up. Cardiac catheterization can be safely performed on patients supported by ECMO. Cardiac catheterization is a critical tool in the early recognition, diagnosis, and direct treatment of hemodynamic/anatomic abnormalities in patients supported by ECMO.

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References

  1. Kanter K, Pennington G, Weber T et al (1987) Extracorporeal membrane oxygenation for postoperative cardiac support in children. J Thorac Cardiovasc Surg 93:27–35

    CAS  PubMed  Google Scholar 

  2. Delius RE (1992) Use of extracorporeal life support. Crit Care Med 20:1216–1222

    Article  CAS  PubMed  Google Scholar 

  3. Dalton HJ (1993) Extracorporeal membrane oxygenation for cardiac rescue in children with severe myocardial dysfunction. Crit Care Med 21:1020–1025

    Article  CAS  PubMed  Google Scholar 

  4. Black MD, Coles JG, Williams WG et al (1995) Determinants of success in pediatric cardiac patients undergoing extracorporeal membrane oxygenation. Ann Thorac Surg 50:133–138

    Article  Google Scholar 

  5. Del Nido PJ (1996) Extracorporeal membrane oxygenation for cardiac support in children. Ann Thorac Surg 61:336–339

    Article  PubMed  Google Scholar 

  6. Duncan BW, Hraska V, Jonas RA et al (1999) Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg 117:529–542

    Article  CAS  PubMed  Google Scholar 

  7. Baffes TG, Fridman JL, Bicoff JP, Whitehill JL (1970) Extracorporeal circulation for support of palliative cardiac surgery in infants. Ann Thorac Surg 10:354–363

    Article  CAS  PubMed  Google Scholar 

  8. Duncan BW (2002) Mechanical circulatory support for infants and children with cardiac disease. Ann Thorac Surg 73:1670–1677

    Article  PubMed  Google Scholar 

  9. Bergersen L, Marshal A, Gauvreau K, Beekman R et al (2010) Adverse events rates in congenital cardiac catheterization—a multi-center experience. Catheter Cardiovasc Interv 75:389–400

    PubMed  Google Scholar 

  10. Booth KL, Roth SJ, Perry SB et al (2002) Cardiac catheterization of patients supported by extracorporeal membrane oxygenation. J Am Coll Cardiol 40:1681–1686

    Article  PubMed  Google Scholar 

  11. Chung M, Shiloh AL, Carlese A (2014) Monitoring of the adult patient on venoarterial extracorporeal membrane oxygenation. Sci World J 2014:1–10

    Google Scholar 

  12. Eastaugh LJ, Thiagarajan RR, Darst JR et al (2015) Percutaneous left atrial decompression in patients supported with extracorporeal membrane oxygenation for cardiac disease. Pediatr Crit care Med 16:59–65

    Article  PubMed  Google Scholar 

  13. Hacking DF, Best D, D’Udekem Y et al (2015) Elective decompression of the left ventricle in pediatric patients may reduce the duration of venoarterial extracorporeal membrane oxygenation. Artif Organs 39:319–326

    Article  PubMed  Google Scholar 

  14. Callahan R, Trucco SM, Wearden PD et al (2015) Outcomes of pediatric patients undergoing cardiac catheterization while on extracorporeal membrane oxygenation. Pediatr Cardiol 36:625–632

    Article  PubMed  Google Scholar 

  15. Hintz SR, Benitz WE, Colby CE et al (2005) Utilization and outcomes of neonatal cardiac extracorporeal life support: 1996–2000. Pediatr Crit Care Med 6:33–38

    Article  PubMed  Google Scholar 

  16. Panda BR, Alphonso N, Govindasamy M et al (2014) Cardiac catheter procedures during extracorporeal life support: a risk-benefit analysis. World J Pediatr Congenit Heart Surg 5:31–37

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank the Columbia University division of Pediatric Cardiology and Pediatric Surgery for their assistance in the study.

Funding

This study was funded by the Columbia University College of Physicians and Surgeons Scholarly Project Program.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital of New York, Columbia University Medical Center, 3959 Broadway, BH2N, New York, NY, 10032, USA

    Nicholas S. Boscamp, Mariel E. Turner, Matthew Crystal, Brett Anderson, Julie A. Vincent & Alejandro J. Torres

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  1. Nicholas S. Boscamp
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  2. Mariel E. Turner
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  3. Matthew Crystal
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  4. Brett Anderson
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  5. Julie A. Vincent
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  6. Alejandro J. Torres
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Correspondence to Nicholas S. Boscamp.

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Conflict of interest

Dr. Julie A. Vincent is a proctor and consultant for Medtronic. Dr. Alejandro J. Torres is a proctor and consultant for BBraun and a proctor for Edwards Lifesciences. The rest of the authors have no conflict of interest or disclosures.

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Boscamp, N.S., Turner, M.E., Crystal, M. et al. Cardiac Catheterization in Pediatric Patients Supported by Extracorporeal Membrane Oxygenation: A 15-Year Experience. Pediatr Cardiol 38, 332–337 (2017). https://doi.org/10.1007/s00246-016-1518-0

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  • DOI: https://doi.org/10.1007/s00246-016-1518-0

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