Emergency Interventional Cardiology in Children
Though infrequent, the performance of an interventional cardiac procedure in an emergent setting can be lifesaving and indicated for various conditions. It is important for clinicians to assess the need to perform emergent catheterization procedures in infants and children in a timely fashion. Based on our experience and that reported in the literature, the seven most common procedures performed emergently on patients seen in the emergency department (ED) will be discussed. These procedures are pericardiocentesis, foreign body retrieval, transvenous pacing lead placement, recanalization of an acutely thrombosed modified Blalock-Taussig shunt, balloon valvuloplasty, balloon atrial septostomy, and intervention for an acute pulmonary embolism. Although most of these procedures require special technical skills, all clinicians need to be aware of their indications and treatment strategies. Timely recognition and subsequent mobilization of the interventional cardiology team are critical in achieving a successful outcome for emergent interventional procedures.
KeywordsPericardiocentesis Foreign body retrieval Transvenous pacing lead placement Aortopulmonary shunt thrombosis Balloon valvuloplasty Balloon atrial septostomy Pulmonary embolism
- 2.Kudumula V, Stumper O, Noonan P, Mehta C, De Giovanni J, Stickley J, Dhillon R, Bhole V. Transcatheter retrieval of cardiovascular foreign bodies in children: a 15-year single centre experience. Pediatr Cardiol. 2017;38(6):1183–90. https://doi.org/10.1007/s00246-017-1639-0. CrossRefPubMedGoogle Scholar
- 4.Feltes TF, Bacha E, Beekman RH III, Cheatham JP, Feinstein JA, Gomes AS, Hijazi ZM, Ing FF, de Moor M, Morrow WR, Mullins CE, Taubert KA, Zahn EM, American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; Council on Cardiovascular Radiology and Intervention; American Heart Association. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011;123(22):2607–52.CrossRefGoogle Scholar
- 7.de Caen AR, Maconochie IK, Aickin R, Atkins DL, Biarent D, Guerguerian AM, Kleinman ME, Kloeck DA, Meaney PA, Nadkarni VM, Ng KC, Nuthall G, Reis AG, Shimizu N, Tibballs J, Veliz Pintos R, Pediatric Basic Life Support and Pediatric Advanced Life Support Chapter Collaborators. Part 6: pediatric basic life support and pediatric advanced life support: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2015;132:S177–203.CrossRefGoogle Scholar
- 8.Tonna JE, Johnson NJ, Greenwood J, Gaieski DF, Shinar Z, Bellezo JM, Becker L, Shah AP, Youngquist ST, Mallin MP, Fair JF III, Gunnerson KJ, Weng C, McKellar S, Extracorporeal REsuscitation ConsorTium (ERECT) Research Group. Practice characteristics of Emergency Department extracorporeal cardiopulmonary resuscitation (eCPR) programs in the United States: the current state of the art of Emergency Department extracorporeal membrane oxygenation (ED ECMO). Resuscitation. 2016;107:38–46.CrossRefGoogle Scholar
- 9.Parekh D, Jeewa A, Tume SC, Dreyer WJ, Pignatelli R, Horne D, Justino H, Qureshi AM. Percutaneous mechanical circulatory support using Impella® Devices for decompensated cardiogenic shock: a pediatric heart center experience. ASAIO J. 2017;64(1):98–104.Google Scholar