Circulation. 1998;97:609-625
(Circulation. 1998;97:609-625.)
© 1998 American Heart Association, Inc.
Pediatric Therapeutic Cardiac Catheterization
A Statement for Healthcare Professionals From the Council on Cardiovascular Disease in the Young, American Heart Association
Hugh D. Allen, MD;
Robert H. Beekman, III, MD;
Arthur Garson, Jr, MD, MPH;
Ziyad M. Hijazi, MD, MPH;
Charles Mullins, MD;
Martin P. O'Laughlin, MD;
; Kathryn A. Taubert, PhD
Key Words: AHA Medical/Scientific Statements • catheterization • pediatrics • defects
Introduction
During the last few years, dramatic changes have
taken place in the pediatric cardiac catheterization
laboratory.1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 Improved noninvasive
diagnostic techniques have narrowed the indications for
diagnostic cardiac catheterization, and the
laboratory is now increasingly being used for therapeutic procedures.
Concern about the appropriateness of some applications of pediatric
therapeutic cardiac catheterization has arisen recently
because of numerous catheter techniques, the increased numbers of
persons and centers using these techniques, and the increased number of
lesion types thought to be amenable to catheter therapy.
In comparison with diagnostic cardiac
catheterization, therapeutic catheter procedures
require more time and resources, are costlier and riskier, and demand
more technical training and expertise. High levels of skill are
required of the operator who performs the various therapeutic
catheterization techniques. These procedures should
only be performed in institutions with appropriate facilities,
personnel, and programs.43 These considerations,
combined with the rapid increase in the number of laboratories and
cardiologists performing therapeutic catheterization
procedures, cause concern about hospital and physician credentialing,
hospital and physician peer review, and human subjects investigational
review. Since publication of the last American Heart Association
statement on pediatric therapeutic cardiac
catheterization,44 many new
devices and applications have been described, prompting this report on
important new techniques in pediatric therapeutic cardiac
catheterization. Because much of the information in
this statement is still investigational, this statement does not
formally represent American College of
Cardiology/American Heart Association (ACC/AHA)
guidelines. However, the authors believe that the recommendations,
which are classified as I, II, and III, represent a consensus.
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