Cardiac catheterization and percutaneus catheter in grown-up congenital heart diseases: single center experience at developing country
Background: Grown-up congenital heart disease (GUCH) patients are unique and challenges especially at developing country. The numbers of diagnostic as well as interventional cardiac catheterization procedures in GUCH patients are growing. The aim of this study was to report the outcome of cardiac catheterization including intervention procedure in GUCH.
Methods: The descriptive study was conducted at Sanglah Hospital, Denpasar, Bali, Indonesia. All patients (age of more than 12 years) who underwent cardiac catheterization from 2011 until 2017 were included in this study. Patients, characteristic, types of catheter procedures, immediate complications, and outcomes were documented.
Results: A total 54 subjects were included with median age of 23 years and 70% were female. The first symptom that brought patients to hospital is dyspnea 46% and palpitation 32%. Five subjects underwent a diagnostic catheter procedure and 49 (91%) diagnostic and catheter based interventions. Transcatheter interventions procedures included atrial septal defect (ASD) (success rate of 20 per 21), patent ductus arteriosus (PDA) (success rate of 16 per16), ventricular septal defect (VSD) (success rate of 9 per 9), pulmonal stenosis (PS) (success rate of 1 per 2), and aortic stenosis (AS) (success rate of 1 per 1). The complications encountered were transient dysrhythmias in 15 subjects, device embolization in 4 subjects, massive bleeding in 1 subject, and overall mortality in 2 subjects.
Conclusion: The number of the catheterization interventions in GUCH was 91% and ASD device closure was the most common procedure. Transcatheter intervention has a high procedural success rates (96%) and low procedural-related complications.
Shahabuddin S, Hashmi S, Rakhshan SE, Khan JK, Sami SA, Amanullah M. Is grown up congenital heart (GUCH) disease different in a developing country? J Pak Med Assoc. 2016;66 (Suppl 3)(10):S5–7.
Arzamendi D, Miro J. Percutaneous intervention in adult congenital heart disease. Rev EspCardiol (Engl Ed).2012;65(8):690–9. https://doi.org/10.1016/j.recesp.2012.02.025
Somerville J. Grown-up congenital heart (GUCH) disease: current needs and provision of service for adolescents and adults with congenital heart disease in the UK. Heart. 2002;88Suppl 1:i1–14.
Sukmana TP, Mulyadi MD, Nikmah SI, Hasri S, Sidigdo S. Transcatheter closure of atrial septal defects in a center with limited resources: outcome and short term follow-up. Iran J Pediatr. 2015;25(6):1–5.
Baumgartner H, Philipp B, Natasja MS, Fokko de H, John ED, Nazzareno G, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010). Eur J Heart. 2010;31(23):2915–57. https://doi.org/10.1093/eurheartj/ehq249
Akagi T. Current concept of transcatheter closure of atrial septal defect in adults. J Cardiol. 2015;65(1):17–25. https://doi.org/10.1016/j.jjcc.2014.09.002
Akagi T. Catheter intervention for adult patient with congenital heart disease. J Cardiol. 2012;60(3):151–9. https://doi.org/10.1016/j.jjcc.2012.06.014
Greutmann M, Tobler D, Kovacs AH, Greutmann-Yantiri M, Haile SR, Held L, et al. Increasing mortality burden among adults with complex congenital heart disease. Congenit Heart Dis. 2015;10 (2):117–27. https://doi.org/10.1111/chd.12201
Diller GP, Gunter B, Helmut B. Congenital heart defect in adulthood. DtschArztebl Int. 2011;108:452–9. https://doi.org/10.3238/arztebl.2011.0452
Gurvitz M, Kristin MB, Ralph B, Craig SB, Curt JD, Stephanie MP, et al. Emerging research directions in adult congenital heart disease a report from an NHLBI/ACHA working group. J Am CollCardiol. 2016;67(16):1956–64. https://doi.org/10.1016/j.jacc.2016.01.062
Al-Balushi A, Hamood AK, Homood AS, Suresh K, Salim AM. Adolescent and adults with congenital heart disease in Oman. Oman Med J. 2015;30(1):26–30. https://doi.org/10.5001/omj.2015.05
Sultan M, Asif M, Maad U, Nadeem S, Khurram A, Hajira A. Cardiac catheterization in grown-up patients with congenital heart disease-indications and complications. Pak Heart J. 2012;45:174–9.
Galie N, Marius MH, Marc H, Adam T, Jean-Luc V, Joan AB, et al. Guideline for the diagnosis and treatment of pulmonary hypertension: The task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur J Heart. 2009;30:2493–537. https://doi.org/10.1093/eurheartj/ehp297
Minai OA, Yared JP, Kaw R, Subramaniam K, Hill NS. Perioperative risk and management in patients with pulmonary hypertension.Chest. 2013;144 (1):329–40. https://doi.org/10.1378/chest.12-1752
Rajdev A, Hasan G, Angelo B. Arrhythmias in pulmonary arterial hypertension. ProgCardiovasc Dis. 2012;55:1–10. https://doi.org/10.1016/j.pcad.2012.06.002
Komar M, Tadeusz P, Maria O, Bartosz S, Piotr P. The benefit of atrial septal defect closure in elderly patients. ClinInterv Aging. 2014;9:1101–7. https://doi.org/10.2147/CIA.S62313
Meyer MR, David JK, Alain MB, Oliver K, Frans RE. Efficacy and safety of transcatheter closure in adults with large or small atrial septal defects. Springerplus. 2016;21(5):1841. https://doi.org/10.1186/s40064-016-3552-z
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