Complications of cardiac catheterisation in congenital heart disease, 30 years of experience. A new risk-adjusted score

Ricardo Gamboa, Servicio de Cardiología Infantil y Cardiopatías congénitas del adulto, Servicio de Hemodinamia, Hospital de Alta Complejidad El Cruce, Florencio Varela, Provincia de Buenos Aires, Argentina
Alfredo Bravo, Servicio de Hemodinamia, Instituto Cardiovascular Villa Mercedes, San Luis, Argentina
Jesús Damsky-Barbosa, Servicio de Cardiología Infantil y Hemodinamia, Hospital Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina
Eduardo Benítez, Servicio de Cardiología, Policlínico Regional de Villa Mercedes, San Luis, Argentina
Pablo Pedroni, Servicio de Hemodinamia, Hospital el Cruce, Florencio Varela, Provincia de Buenos Aires, Argentina
Martín Roth, Servicio de Anestesiología, Hospital Garrahan. Ciudad Autónoma de Buenos Aires, Argentina
Francisco Pedro Mollón, Servicio de Hemodinamia, Clínica Guemes, Luján, Provincia de Buenos Aires, Argentina
Estefanía Solari, Instituto de Investigaciones Administrativas, Facultad de Ciencias Económicas, Universidad Nacional de La Plata, La Plata, Provincia de Buenos Aires. Argentina

Objetive: to present a risk-ajusted score of complications during cardias catheterization in congenital heart disease. Design: observational, analitic, ambispective of 3.504 cases. The data analyzed included age, heart disease, type of procedure, major and minor complications. Methods: 3.504 procedures performed between october 1987 and may 2019. The variables were age, heart disease, procedere and clinical stege. Each patients was categorized as low risk 5 to 7 points, moderate risk 8 to 11 points and higt risk 12 to 22 points. The score was validated using the Hosmer-Lemeshow test and the ROC curve (Receiver Operating Characteristic). Results: complications 177 (5%) 66 major (1.9%) and 111 minor (3.1%). Mortality was 0.4% (15 patients). The low-risk group (n = 825) had 1.5% complications; moderate risk (n = 2,221) 4.9%; high risk (n: 458) 12% (p < 0.001). The analysis of the retrospective data (n = 2953) was validated with prospective (n = 551) using the Hosmer-Lemeshow test, showed that the predicted values are similar to those observed. Conclusions: Complications continue to occur despite the evolution of the technique. The score was useful for stratifying patients and knowing the probability of complication before the procedere.

Keywords: Complications. Diagnostic and interventional catheterization. Congenital heart disease.