Retrospective evaluation of transcatheter interventional cardiac procedures in newborns with critical congenital heart diseases

Retrospective Evaluation of Transcatheter Interventional Cardiac Procedures in Newborns with Critical Congenital Heart Diseases Aim: Cardiac malformations are the most common cause of mortality in newborns. Early diagnosis and treatment of critical congenital heart diseases in newborns are crucial for reducing morbidity and mortality. This study aims to retrospectively evaluate the outcomes of patients admitted to our hospital with a diagnosis of critical congenital heart disease who underwent interventional cardiac procedures during the neonatal period, and to assess the factors influencing these outcomes. Methods: Between 1993 and 2023, diagnostic methods, procedural outcomes, complications, mortality rates, and influencing factors were evaluated in newborns and premature infants who underwent diagnostic cardiac catheterization and angiocardiology procedures for the treatment of critical congenital heart disease by the Department of Pediatric Cardiology at our hospital. Results: In this study, interventional cardiac procedures were performed on 430 patients with critical congenital heart disease. Of the patients, 60.2% were male, 39.8% were female, with a male-to-female ratio of 1.5:1. Preterm infants constituted 8.6%, and the average age during the procedure was 16 days (median 14 days; 1–64 days). Diagnosis was established in 56% of patients when symptomatic, 26% through screening examinations, and 18% via fetal echocardiography. Among the patients, 38% had diseases related to the ductus in the pulmonary circulation, 34% had diseases related to the ductus in the systemic circulation, and 28% had transposition of the great arteries. Therapeutic interventional procedures included 33% balloon atrial septostomies, 30% pulmonary balloon valvuloplasties, 22% balloon angioplasties, 10% aortic balloon valvuloplasties, and 5% ductal stent placement procedures. Overall, 84% of the procedures (n=362) were considered successful. Among all patients who underwent interventional cardiac procedures, 25.3% (109 patients) experienced minor complications, and 5.3% (23 patients) experienced major complications. The most common minor complication was temporary circulation disturbance in the extremities, while transfusion-requiring bleeding stood out among major complications. Conclusion: In recent years, technological advancements have made pediatric cardiac interventional procedures an alternative to surgery in many cases, even in newborns. The type and frequency of interventional cardiac procedures in newborns have undergone changes over the years. Although complications are more frequent in newborns, with increasing experience in centers and advancing technology, complications are gradually decreasing. The more frequent and effective use of early diagnostic opportunities will further reduce morbidity and mortality. Keywords: newborn, interventional procedure, cardiac catheterization, critical congenital heart diseases, complications