Safety of outpatient cardiac catheterisation in infants with single-ventricle or shunt-dependent biventricular congenital heart disease

Abstract

ObjectiveWe aimed to investigate the incidence and causes of readmission of infants with single-ventricle and shunt-dependent biventricular CHD following routine, outpatient cardiac catheterisation.BackgroundCardiac catheterisation is commonly performed in patients with single-ventricle and shunt-dependent biventricular CHD for haemodynamic assessment and surgical planning. Best practices for post-procedural care in this population are unknown, and substantial variation exists between centres. Outpatient catheterisation reduces parental anxiety and decreases cost. Our institutional strategy is to discharge patients following a 4- to 6-hour post-procedure observation period.MethodsRetrospective cohort study using the Society of Thoracic Surgeons Database identified patients <1 year of age with pre-stage II single-ventricle CHD or shunt-dependent biventricular CHD who underwent cardiac catheterisation between 2007 and 2015. Readmission was defined as admission to the hospital within 48 hours after discharge after catheterisation.ResultsA total of 92 patients were included in the analysis. Among them, 62 patients (67%) were discharged after a 4- to 6-hour observation period with only 3% readmission, 18 patients (20%) stayed for a 23-hour observation period, and 12 patients (13%) were admitted for >23 hours. There were no differences in baseline characteristics between discharged and admitted patients. Patients who underwent intervention were more likely to be admitted. Patients with hypoplastic left heart syndrome did not have major adverse events or readmissions. No intra- or peri-procedural deaths occurred.ConclusionsOutpatient cardiac catheterisation may be a safe option for infants with single-ventricle and shunt-dependent biventricular CHD, with low readmission rates and minimal morbidity.

Economic implications of outpatient cardiac catheterisation in infants with single ventricle congenital heart disease

“…Median age in the discharged group was 132 days, and 137 days in the admitted group (Table 1). 9 The most common diagnosis was hypoplastic left heart syndrome (34.8%) (Fig 2). 9 Sixty-two patients were discharged the same day as cardiac catheterisation.…”

“…9 The most common diagnosis was hypoplastic left heart syndrome (34.8%) (Fig 2). 9 Sixty-two patients were discharged the same day as cardiac catheterisation. Two of those patients were readmitted to the hospital within 48 hours.…”

“…[5][6][7][8] Substantial variability in post-procedure care exists in these patients following cardiac catheterisation, and recent reports suggest that same-day discharge can be performed safely. 9 The purpose of this study was to investigate the economic implications of planned same-day discharge versus universal overnight hospital admission following routine pre-surgical cardiac catheterisation in infants with single ventricle heart disease.…”