Outcome of Interventional Cardiac Catheterization in Infants Weighing Less Than 2500 Grams: A Comparative Study

ABSTRACT Objectives: A retrospective study to evaluate the outcome of interventional cardiac catheterization in infants weighing <2500 grams. Background: The mortality of small weight infants undergoing heart surgery remains high, so cardiac catheterization has been utilized to improve the outcome. Methods: The study included infants who underwent interventional cardiac catheterization within the first 60 days of life in New Children Cairo University Hospital, Cairo, Egypt from January 2015 to January 2018. The study group included infants < 2500 grams while the comparative group included infants ≥ 2500 grams. Adverse events were classified according to the mechanism and seriousness. Results: The study group (37 patients) had a mean weight of 2.35 ±0.13 Kg, while the comparative group (164 patients) had a mean weight of 3.54 ±0.71 Kg. The procedures included balloon atrial septostomy, pulmonary balloon valvuloplasty, ductus arteriosus stenting and radiofrequency perforation of pulmonary atresia. The study group showed less success rates as compared with the comparative group (83.8% versus 93.9%, p = 0.04), and higher incidence of overall adverse events (48.6% versus 20.1 %, p<0.001) as well as catheterization-related mortality (29.7% versus 4.9%, P<0.001). In the study group, pulmonary balloon valvuloplasty showed the highest incidence of major adverse events while ductus arteriosus stenting had the highest incidence of mortality. Conclusions: Compared to normal weight infants, interventional cardiac catheterization in small weight infants is associated with lower success and higher morbidity and mortality rates. Pulmonary balloon valvuloplasty and ductus arteriosus stenting have the highest morbidity and mortality, respectively.