TY - JOUR

T1 - Adverse events in transcatheter interventions for congenital heart disease

T2 - a population-based long-term study

AU - Larsen, Signe Holm

AU - Emmertsen, Kristian

AU - Hjortdal, Vibeke Elisabeth

AU - Nielsen-Kudsk, Jens Erik

N1 - © 2014 Wiley Periodicals, Inc.

PY - 2014/9/10

Y1 - 2014/9/10

N2 - OBJECTIVE: Few studies have reported procedure complications or adverse events for transcatheter interventions in unselected congenital heart disease cohorts. We report our 23-year experience with transcatheter interventions in congenital heart disease and examine predictors for adverse events.DESIGN AND SETTING: This study was a population-based cohort study of children and adults with congenital heart disease, covering a population of 3 million inhabitants in western Denmark. Adverse events were subdivided into 5 levels according to their severity. Procedure-type risk category, age, weight, and year of procedure were included in multivariate logistic models to identify risk factors for adverse events.RESULTS: Between 1990 and 2012, 1595 patients had 1878 catheter-based interventions performed. We identified 241 adverse events, corresponding to 13% of the procedures; 58 (3%) were considered to be of high severity. During the study period, there was an increase in number of procedures per year (P < .001) and a decrease in frequency of adverse events (P = .01). Procedure-type categories 3 and 4 had increased risk of adverse events when compared with category 2, with odds ratios of 1.7 (95% confidence interval [CI]: 1.2-2.3) for category 3 and 2.3 for category 4 (95% CI: 1.4-3.6). Age and weight at catheterization were not independently associated with adverse events.CONCLUSIONS: We found an increase in number of procedures over time and a decrease in frequency of adverse events. Higher procedure-type risk categories were associated with increased risk of adverse events.

AB - OBJECTIVE: Few studies have reported procedure complications or adverse events for transcatheter interventions in unselected congenital heart disease cohorts. We report our 23-year experience with transcatheter interventions in congenital heart disease and examine predictors for adverse events.DESIGN AND SETTING: This study was a population-based cohort study of children and adults with congenital heart disease, covering a population of 3 million inhabitants in western Denmark. Adverse events were subdivided into 5 levels according to their severity. Procedure-type risk category, age, weight, and year of procedure were included in multivariate logistic models to identify risk factors for adverse events.RESULTS: Between 1990 and 2012, 1595 patients had 1878 catheter-based interventions performed. We identified 241 adverse events, corresponding to 13% of the procedures; 58 (3%) were considered to be of high severity. During the study period, there was an increase in number of procedures per year (P < .001) and a decrease in frequency of adverse events (P = .01). Procedure-type categories 3 and 4 had increased risk of adverse events when compared with category 2, with odds ratios of 1.7 (95% confidence interval [CI]: 1.2-2.3) for category 3 and 2.3 for category 4 (95% CI: 1.4-3.6). Age and weight at catheterization were not independently associated with adverse events.CONCLUSIONS: We found an increase in number of procedures over time and a decrease in frequency of adverse events. Higher procedure-type risk categories were associated with increased risk of adverse events.

KW - Adolescent

KW - Cardiac Catheterization/adverse effects

KW - Cardiac Surgical Procedures/adverse effects

KW - Child

KW - Child, Preschool

KW - Cohort Studies

KW - Female

KW - Heart Defects, Congenital/surgery

KW - Heart Diseases/congenital

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Postoperative Complications/epidemiology

KW - Prognosis

KW - Retrospective Studies

KW - Time Factors

U2 - 10.1111/chd.12218

DO - 10.1111/chd.12218

M3 - Journal article

C2 - 25196278

VL - 10

SP - 153

EP - 158

JO - Congenital Heart Disease

JF - Congenital Heart Disease

SN - 1747-079X

IS - 2

ER -