Paediatric cardiac catheterisation: The experience of a Moroccan University Hospital Centre

Background Cardiac catheterisation was considered the gold standard for confirmation of diagnosis and analyzing various management issues in congenital heart diseases. It is now frequently used for therapeutic reasons. Purpose Our study aims to describe the current state of paediatric catheterisation and analyse the type, the result, the anaesthetic principles and the main complications of the performed procedures. Methods This was a retrospective study conducted in the Cardiology department in conjunction with the Paediatric Resuscitation-Anaesthesia department at the University Hospital Centre of Casablanca from January 2013 to June 2017, including patients having undergone paediatric catheterisation. Results Fifty patients were included. The male sex was more common with a sex ratio of 1.4 and the mean age was 5.5 years. In total, 74% of patients underwent interventional catheterisation; the main indications were Rashkind's atrioseptostomy (26%), dilatation of pulmonary stenosis (21%), and the success rate was 95%. A diagnostic catheterization was performed in 26% of cases mainly in the Tetralogy of Fallot (31%) and the Ventricular septal defect (23%) in order to explore the anatomy, the hemodynamics and to look for pulmonary hypertension that will determine the operability; 67% were operable. Concerning anaesthesia, the controlled administration of anesthetics and the appropriate monitoring were necessary for the proper course of interventions. Complications occur in 18% of cases including post-procedure infection (4%), death (4%) by cardiorespiratory arrest and septic shock, bleeding from the puncture site (4%), acute limb ischemia (2%), extreme bradycardia (2%) and allergic reaction to contrast (2%) ( Fig. 1 ). Conclusion Interventional paediatric catheterisation has grown remarkably in Morocco. These procedures have become the treatment of choice for many cardiac lesions, and serve as alternatives or adjuncts to surgical treatment.