Transcatheter Cardiac Intervention in Neonates: Experience From a Tertiary Care Centre in Bangladesh
Abstract
Background: Critical congenital heart disease (cCHD) is the most common reason requiring surgery or catheter- based intervention in the neonatal period. Transcatheter interventions in neonates present unique challenges in Bangladesh due to limited resources, unavailability of hardware, cost of procedure, low birth weight, sepsis, and delayed diagnosis. Careful technique, proper planning & safety measures reduces the incidence of complications. Methods: This retrospective study was conducted in the cardiac centre of Bangladesh Shishu Hospital & Institute between June 2014 to June 2022.Total 322 sick neonates required cardiac interventions during the study period. Clinical parameters, SPO2, echocardiographic data, cathlab data & outcome were recorded. Statistical analysis was done by using SPSS version 24.Results: Among 322 patients balloon atrial septostomy was done in 143(44%) patients mostly for DTGA PFO/small secundum ASD ± small PDA. 113 (35%) patients underwent PDA stenting for duct dependent pulmonary circulation. For severe stenosis with or without ventricular dysfunction 14 patients underwent balloon aortic valvuloplasty, 17 patients for balloon pulmonary valvuloplasty and 31 patients for coarctoplasty. There was significant reduction of mean gradient across the stenosis (p<0.05). Three patients with membranous pulmonary atresia with intact IVS underwent pulmonary valve perforation using CTO guide wire & one neonate with TOF with severe cyanosis underwent RVOT stenting successfully. Mean age for BAS patients was 14 days ± 10 days and mean weight 2.6 ± 0.72 Kg. Mean age for PDA stenting patients was 16 days ± 12 days and mean weight 2.5± 0.69 Kg.
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References
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