Changes in the Cath Lab in the Treatment of Adult Patients with Congenital Heart Disease: A 12-Year Experience in a Single Referral Center with the Establishment of a Dedicated Working Group
Authors:
- Maria Giulia GagliardiMaria Giulia Gagliardi
- Roberto FormigariRoberto Formigari
- Marco Alfonso PerroneMarco Alfonso Perrone
- Elettra PomiatoEPElettra Pomiato
- Francesca FanisioFFFrancesca Fanisio
- Mario PanebiancoMPMario Panebianco
- Rosaria BarracanoRBRosaria Barracano
- Paolo GuccionePaolo Guccione
- Rosalinda PalmieriRPRosalinda Palmieri
- Massimiliano RaponiMRMassimiliano Raponi
- Lorenzo GallettiLorenzo Galletti
Open Access
- 25 July 2023
- journal article
- research article
- Published by MDPI AG in Journal of Cardiovascular Development and Disease
- Vol. 10 (8) , 314
Abstract
Background: Adults with congenital heart disease (ACHD) are a growing population needing ongoing care. The aim of this study was to investigate if a dedicated ACHD team impacted the timing and indication of invasive cardiology procedures in these patients at our hospital. Methods: Our retrospective single-center study enrolled adult patients with moderate or complex congenital heart disease and with at least one cardiac catheterization between January 2010 and December 2021. According to the period, procedures were labeled as group A (2010 to 2015) or group B (2016 to 2021) and further divided into diagnostic (DCC) and interventional cardiac catheterizations (ICC). Results: 594 patients were eligible for the study. Both DCC (p < 0.05) and ICC increased between groups A and B (p < 0.05). In group B: Fontan patients accounted for the majority of DCC (p < 0.001), while DCC decreased in arterial switch repair (p < 0.001). In Fontan patients, conduit stenting was prevalent (p < 0.001), while fenestration closures dropped (p < 0.01). In patients with tetralogy of Fallot and native outflow tract, percutaneous pulmonary valve implantations (PPVI) increased, with a concurrent reduction in pulmonary valve replacements (p < 0.001 vs. surgical series). In right ventricular conduits, ICC increased (p < 0.01), mainly due to PPVI. Among Mustard/Senning patients, baffle stenting increased from Group A to Group B (p < 0.001). In patients with pulmonary atresia and biventricular repair, ICC often increased for pulmonary artery stenting. Conclusions: A dedicated working group could improve ACHD patients’ indications for interventional procedures, leading to tailored treatment, better risk stratification and optimizing time until heart transplantation.Keywords
This publication has 23 references indexed in Scilit:
- 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart DiseaseJACC, 2019
- Management errors in adults with congenital heart disease: prevalence, sources, and consequencesEuropean Heart Journal, 2017
- Procedural Results and Safety of Common Interventional Procedures in Congenital Heart DiseaseJACC, 2014
- Lifetime Prevalence of Congenital Heart Disease in the General Population From 2000 to 2010Circulation, 2014
- Specialized Adult Congenital Heart Disease CareCirculation, 2014
- Adverse events rates and risk factors in adults undergoing cardiac catheterization at pediatric hospitals—results from the C3POCatheterization and Cardiovascular Interventions, 2013
- The prevalence of adult congenital heart disease, results from a systematic review and evidence based calculationAmerican Heart Journal, 2012
- The impact of interventional cardiology for the management of adults with congenital heart defectsCatheterization and Cardiovascular Interventions, 2006
- Is it safe to perform cardiac catheterizations on adults with congenital heart disease in a pediatric catheterization laboratory?Catheterization and Cardiovascular Interventions, 2005
- Care of the adult with congenital heart disease: introductionJACC, 2001