Interventional methods in pediatric cardiology in a 20-year period

    Authors

    Keywords

    interventional cardiology, children, follow-up, development

    DOI

    https://doi.org/10.15836/ccar2016.135

    Full Text

    Development of interventional cardiology in treating heart diseases in children in the Reference Centre for Pediatric Cardiology (1) in the last 20 years (1996 - 2015) is presented. Constant growth in the number of heart catheterizations (from 160 to 241) is followed by a relatively higher growth in the number of interventional catheterizations (from 12.5% to 38.1%). While the number of catheterizations (**Table 1**) has increased by 50% (160 to 241 =1,5), the number of interventional catheterizations has increased by more than 200% (12.5 – 38.1% > 3). In our conditions these data point to an absolute increase of interventional treatment when compared to the diagnostic heart catheterization itself, despite the fact that the latest diagnostic methods are still not applied sufficiently (MSCT, MRI, 3D ECHO and other). Providing we decrease the number if diagnostic catheterizations by applying the mentioned new diagnostic methods, and based on the expected number of interventional catheterizations curve, the 50% level may be expected in about 5 years. All age groups from newborns, including prematures, to the age of 18 are represented. That implies a tremendous body mass span, with the lowest birth mass being 2000 grams at the time of diagnostic catheterization, and 2400 grams at the time of interventional catheterization. In the last twenty years 3695 heart catheterizations have been performed, 937 of which were interventional (averagely 26%). ### Table 1: Development of invasive diagnostics and of interventional heart catheterization in the last 20 years (1996-2015) in the Reference Centre for Pediatric Cardiology University Hospital Centre Zagreb. | Year | Number of heart catheterization | Number of interventions | percentage of interventions in the overall number of catheterizations | estimated number of interventions based on the number of interventions in the previous year | | --- | --- | --- | --- | --- | | 1996 | 160 | 20 | 12,5% | - | | 1997 | 91 | 17 | 18,9% | 11 | | 1998 | 90 | 24 | 26,8% | 17 | | 1999 | 168 | 16 | 9,5% | 45 | | 2000 | 186 | 21 | 11,3% | 18 | | 2001 | 186 | 41 | 22,0% | 21 | | 2002 | 176 | 27 | 15,3% | 39 | | 2003 | 161 | 25 | 15,5% | 25 | | 2004 | 190 | 48 | 25,4% | 30 | | 2005 | 170 | 32 | 18,8% | 43 | | 2006 | 194 | 52 | 26,8% | 37 | | 2007 | 182 | 60 | 33,0% | 49 | | 2008 | 201 | 65 | 32,3% | 66 | | 2009 | 224 | 70 | 31,3% | 72 | | 2010 | 206 | 68 | 33.0% | 66 | | 2011 | 230 | 78 | 33.9% | 76 | | 2012 | 210 | 72 | 34.3% | 71 | | 2013 | 194 | 62 | 31.6% | 67 | | 2014 | 235 | 83 | 35.3% | 75 | | 2015 | 241 | 92 | 38.1% | 85 | | Overall | 3695 | 973 | 26.33% | | In interventional procedures we employed 12 different surgical procedures, thus equaling the developed pediatric cardiology centers in Europe. Cardiac surgeons and anesthesiologists also participate in the work of pediatric cardiologists. Along with statistic data we are also presenting various interventional skills in pediatric cardiology, from balloon atrioseptostomy to stent implantation.

    Literature

    1. Malcić I, Kniewald H, Sarić D, Gjergja Z, Dasović-Buljević A, Anić D, et al. The development of interventional catheterisation in the referral centre for pediatric cardiology of the Republic of Croatia--a retrospective study 1996-2009. Lijec Vjesn. 2011;133(7-8):241–9. https://pubmed.ncbi.nlm.nih.gov/22165190/
    Cardiologia Croatica
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    Interventional methods in pediatric cardiology in a 20-year period

    Abstract
    Issue3-4
    Published
    Pages135-136
    PDF via DOIhttps://doi.org/10.15836/ccar2016.135
    interventional cardiology
    children
    follow-up
    development

    Authors

    Ivan Malčić*ORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Dalibor ŠarićUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Hrvoje KniewaldORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Daniel DilberUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Dorotea BartoničekUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Darko AnićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Višnja IvančanORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Dražen BelinaUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Alen HodalinUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

    *Correspondence email: ivan.malcic1@gmail.com

    Full Text

    Development of interventional cardiology in treating heart diseases in children in the Reference Centre for Pediatric Cardiology (1) in the last 20 years (1996 - 2015) is presented.

    Constant growth in the number of heart catheterizations (from 160 to 241) is followed by a relatively higher growth in the number of interventional catheterizations (from 12.5% to 38.1%). While the number of catheterizations (Table 1) has increased by 50% (160 to 241 =1,5), the number of interventional catheterizations has increased by more than 200% (12.5 – 38.1% > 3). In our conditions these data point to an absolute increase of interventional treatment when compared to the diagnostic heart catheterization itself, despite the fact that the latest diagnostic methods are still not applied sufficiently (MSCT, MRI, 3D ECHO and other). Providing we decrease the number if diagnostic catheterizations by applying the mentioned new diagnostic methods, and based on the expected number of interventional catheterizations curve, the 50% level may be expected in about 5 years. All age groups from newborns, including prematures, to the age of 18 are represented. That implies a tremendous body mass span, with the lowest birth mass being 2000 grams at the time of diagnostic catheterization, and 2400 grams at the time of interventional catheterization. In the last twenty years 3695 heart catheterizations have been performed, 937 of which were interventional (averagely 26%).

    Table 1: Development of invasive diagnostics and of interventional heart catheterization in the last 20 years (1996-2015) in the Reference Centre for Pediatric Cardiology University Hospital Centre Zagreb.

    1996
    Number of heart catheterization
    160
    Number of interventions
    20
    percentage of interventions in the overall number of catheterizations
    12,5%
    estimated number of interventions based on the number of interventions in the previous year
    -
    1997
    Number of heart catheterization
    91
    Number of interventions
    17
    percentage of interventions in the overall number of catheterizations
    18,9%
    estimated number of interventions based on the number of interventions in the previous year
    11
    1998
    Number of heart catheterization
    90
    Number of interventions
    24
    percentage of interventions in the overall number of catheterizations
    26,8%
    estimated number of interventions based on the number of interventions in the previous year
    17
    1999
    Number of heart catheterization
    168
    Number of interventions
    16
    percentage of interventions in the overall number of catheterizations
    9,5%
    estimated number of interventions based on the number of interventions in the previous year
    45
    2000
    Number of heart catheterization
    186
    Number of interventions
    21
    percentage of interventions in the overall number of catheterizations
    11,3%
    estimated number of interventions based on the number of interventions in the previous year
    18
    2001
    Number of heart catheterization
    186
    Number of interventions
    41
    percentage of interventions in the overall number of catheterizations
    22,0%
    estimated number of interventions based on the number of interventions in the previous year
    21
    2002
    Number of heart catheterization
    176
    Number of interventions
    27
    percentage of interventions in the overall number of catheterizations
    15,3%
    estimated number of interventions based on the number of interventions in the previous year
    39
    2003
    Number of heart catheterization
    161
    Number of interventions
    25
    percentage of interventions in the overall number of catheterizations
    15,5%
    estimated number of interventions based on the number of interventions in the previous year
    25
    2004
    Number of heart catheterization
    190
    Number of interventions
    48
    percentage of interventions in the overall number of catheterizations
    25,4%
    estimated number of interventions based on the number of interventions in the previous year
    30
    2005
    Number of heart catheterization
    170
    Number of interventions
    32
    percentage of interventions in the overall number of catheterizations
    18,8%
    estimated number of interventions based on the number of interventions in the previous year
    43
    2006
    Number of heart catheterization
    194
    Number of interventions
    52
    percentage of interventions in the overall number of catheterizations
    26,8%
    estimated number of interventions based on the number of interventions in the previous year
    37
    2007
    Number of heart catheterization
    182
    Number of interventions
    60
    percentage of interventions in the overall number of catheterizations
    33,0%
    estimated number of interventions based on the number of interventions in the previous year
    49
    2008
    Number of heart catheterization
    201
    Number of interventions
    65
    percentage of interventions in the overall number of catheterizations
    32,3%
    estimated number of interventions based on the number of interventions in the previous year
    66
    2009
    Number of heart catheterization
    224
    Number of interventions
    70
    percentage of interventions in the overall number of catheterizations
    31,3%
    estimated number of interventions based on the number of interventions in the previous year
    72
    2010
    Number of heart catheterization
    206
    Number of interventions
    68
    percentage of interventions in the overall number of catheterizations
    33.0%
    estimated number of interventions based on the number of interventions in the previous year
    66
    2011
    Number of heart catheterization
    230
    Number of interventions
    78
    percentage of interventions in the overall number of catheterizations
    33.9%
    estimated number of interventions based on the number of interventions in the previous year
    76
    2012
    Number of heart catheterization
    210
    Number of interventions
    72
    percentage of interventions in the overall number of catheterizations
    34.3%
    estimated number of interventions based on the number of interventions in the previous year
    71
    2013
    Number of heart catheterization
    194
    Number of interventions
    62
    percentage of interventions in the overall number of catheterizations
    31.6%
    estimated number of interventions based on the number of interventions in the previous year
    67
    2014
    Number of heart catheterization
    235
    Number of interventions
    83
    percentage of interventions in the overall number of catheterizations
    35.3%
    estimated number of interventions based on the number of interventions in the previous year
    75
    2015
    Number of heart catheterization
    241
    Number of interventions
    92
    percentage of interventions in the overall number of catheterizations
    38.1%
    estimated number of interventions based on the number of interventions in the previous year
    85
    Overall
    Number of heart catheterization
    3695
    Number of interventions
    973
    percentage of interventions in the overall number of catheterizations
    26.33%

    In interventional procedures we employed 12 different surgical procedures, thus equaling the developed pediatric cardiology centers in Europe. Cardiac surgeons and anesthesiologists also participate in the work of pediatric cardiologists. Along with statistic data we are also presenting various interventional skills in pediatric cardiology, from balloon atrioseptostomy to stent implantation.

    Literature

    1. 1.
      Malcić I, Kniewald H, Sarić D, Gjergja Z, Dasović-Buljević A, Anić D, et al. The development of interventional catheterisation in the referral centre for pediatric cardiology of the Republic of Croatia--a retrospective study 1996-2009. Lijec Vjesn. 2011;133(7-8):241–9.PubMed