Neonatal cardiac catheterization: A 10-year transition from diagnosis to therapy

To assess the changing role of cardiac catheterization in the care of the n eonate, a retrospective review of all catheterizations between January 1984 to December 1985 (group I) and January 1994 to December 1995 (group II) at C.S. Mott Children's Hospital was performed. Neonatal cardiac catheterizat ion was performed more frequently (p = 0.02) in group I, comprising 14% (11 0 of 772) of all catheterizations versus 11% (93 of 880) in group II. Acces s was performed by cutdown in 15 patients (13 venous and 2 arterial), all i n group I. In group I, 20 of 110 patients (18%) had balloon atrial septosto mies; no other catheter interventions were performed. Interventions were mo re frequent (p = 0.003) and varied in group TI, including 15 septostomies, 17 balloon valvuloplasties (13 pulmonary and 4 aortic), 2 coil embolization s of collaterals, and 1 cardiac biopsy. Despite the higher prevalence and c omplexity of interventions in group II, fluoroscopy times (median; range: 1 6 min; 2-55 vs 16 min; 1-107) were similar in both groups (p, = not signifi cant) as well as the prevalence of complications. Neonatal cardiac catheter izations are per formed less frequently than they were a decade ago at our institution, and therapeutic interventions have become more common. Despite these changes, fluoroscopy time and the rate of complications have not inc reased.