PMID- 32205313
OWN - NLM
STAT- MEDLINE
DCOM- 20210628
LR  - 20210628
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 106
IP  - 18
DP  - 2020 Sep
TI  - Cardiac catheter intervention complexity and safety outcomes in adult congenital 
      heart disease.
PG  - 1432-1437
LID - 10.1136/heartjnl-2019-316148 [doi]
AB  - OBJECTIVE: To describe the intervention spectrum, complexity, and safety outcomes 
      of catheter-based interventions in a contemporary adult congenital heart disease 
      (ACHD) tertiary cohort. METHODS: All patients over 16 years who underwent a 
      catheter-based intervention for ACHD in our centre between 2000 and 2016 were 
      included. Baseline demographics, clinical characteristics, indications for and 
      complexity of intervention, procedural complications and early and mid-term 
      mortality were analysed. RESULTS: Overall, 1644 catheter-based interventions were 
      performed. Intervention complexity ranged from simple (67.5%) to intermediate 
      (26.4%) and to high (6.1%). Commonly performed procedures were atrial septal 
      defect (33.4%) and patent foramen ovale closure (26.1%) followed by coarctation 
      of the aorta (11.1%) and pulmonary artery interventions (7.0%). Age at index 
      intervention was 40+/-16 years, 758 (46.1%) patients were male, 73.2% in New York 
      Heart Association (NYHA) class I, 20.2% in NYHA class II, whereas 6.6% in NYHA 
      class III/IV. In-hospital mortality was 0.7%. Median postinterventional length of 
      stay was 1 day. Complications occurred in 129 (7.9%) with major adverse events in 
      21 (1.3%). One-year postintervention survival rates were 98.7% (95% CI 98.2 to 
      99.2). Over the study period, there was a notable shift in intervention 
      complexity, with a predominance of simple procedures performed in early years and 
      more complex procedures in later years. Furthermore, the case mix during the 
      study broadened (p<0.001) with new catheter-based interventions and a more 
      individualised approach to therapy. CONCLUSION: This study shows an increasing 
      complexity and expanding variability of ACHD catheter-based interventions, 
      associated with low major complications, short hospital stays and low early and 
      mid-term mortality. Ongoing investment in ACHD catheter interventions is 
      warranted.
CI  - (c) Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Brida, Margarita
AU  - Brida M
AUID- ORCID: 0000-0001-8754-8156
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK margarita.brida@icloud.com.
AD  - Division of Adult Congenital Heart Disease, Department of Cardiovascular 
      Medicine, University Hospital Centre, Zagreb, Croatia.
AD  - National Heart and Lung Institute, Imperial College London, London, UK.
FAU - Diller, Gerhard Paul
AU  - Diller GP
AUID- ORCID: 0000-0003-3050-5248
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and 
      Angiology, University Hospital Muenster, Muenster, Germany.
FAU - Nashat, Heba
AU  - Nashat H
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Barracano, Rosaria
AU  - Barracano R
AUID- ORCID: 0000-0002-6380-073X
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Kempny, Aleksander
AU  - Kempny A
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - National Heart and Lung Institute, Imperial College London, London, UK.
FAU - Uebing, Anselm
AU  - Uebing A
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Rigby, Michael L
AU  - Rigby ML
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
FAU - Gatzoulis, Michael A
AU  - Gatzoulis MA
AD  - Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal 
      Brompton Hospital, London, UK.
AD  - National Heart and Lung Institute, Imperial College London, London, UK.
LA  - eng
GR  - BHF_/British Heart Foundation/United Kingdom
GR  - DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200323
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Cardiac Catheterization/adverse effects/mortality
MH  - Female
MH  - Heart Defects, Congenital/diagnosis/mortality/physiopathology/*therapy
MH  - Humans
MH  - London
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Survivors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - congenital heart disease
OT  - interventional cardiology and endovascular procedures
COIS- Competing interests: None declared.
EDAT- 2020/03/25 06:00
MHDA- 2021/06/29 06:00
CRDT- 2020/03/25 06:00
PHST- 2019/10/27 00:00 [received]
PHST- 2020/01/29 00:00 [revised]
PHST- 2020/02/04 00:00 [accepted]
PHST- 2020/03/25 06:00 [pubmed]
PHST- 2021/06/29 06:00 [medline]
PHST- 2020/03/25 06:00 [entrez]
AID - heartjnl-2019-316148 [pii]
AID - 10.1136/heartjnl-2019-316148 [doi]
PST - ppublish
SO  - Heart. 2020 Sep;106(18):1432-1437. doi: 10.1136/heartjnl-2019-316148. Epub 2020 
      Mar 23.