Objectives- The aim of this study was a prospective evaluation to determine the ‎relative risks and COMPLICATIONS of PEDIATRIC diagnostic and interventional ‎CATHETERIZATIONs‏.‏‎‎ Background- The role of the PEDIATRIC CATHETERIZATION laboratory has evolved in the ‎last decade as a therapeutic modality, although remaining an important tool for ‎anatomic and hemodynamic diagnosis‏.‏‎ ‎ Methods- A study of 480 consecutive PEDIATRIC CATHETERIZATION procedures was ‎undertaken prospectively during 6 months, from October 2001 to March 2002‎‏.‏ Results- Patient ages ranged from 4 days to 17 years (mean 4.5 years). Forty six ‎COMPLICATIONS occurred (9.58% of all cases) and were classified as major ‎COMPLICATIONS in 6 patients, (1.25% of all cases) and minor COMPLICATIONS in 40 ‎patients. (8.33% of all cases)Arrhythmia (n=15) and vascular COMPLICATIONS (n=10) ‎were the most common adverse events respectively. Death occurred in 2 patients ‎‎(0.41‎‏ ‏‎%).‎ ‎‎ Conclusions- The results are acceptable at our center, but efforts should be directed to ‎improving equipment for flexibility and size and improving techniques for decreasing ‎the mortality and morbidity rates (Iranian Heart Journal 2002, 2003; 3(4)&4(1): 29-‎‎33).‎

Context: In the past 20 to 30 years, the area of PEDIATRIC interventional cardiology has had noteworthy development. Technological revolutions have significantly progressed management of cardiovascular disease in both children and adults with congenital heart disease (CHD). This article reviews the current indications, techniques and COMPLICATIONS of interventional therapy for CHD.Evidence Acquisition: Training and publications in this field are rare. Overall, 64 article from January 1953 to February 2014 were studied. A total of 26 articles were involved in PEDIATRIC evaluation.Results: There have been several catheter-based interventions for congenital heart disease. Percutaneous intervention in PEDIATRIC CARDIAC disease has been established in the past 2 to 3 decades. There are currently devices accepted for percutaneous closure of ASDs, patent ductus arteriosus (PDAs), and muscular ventricular septal defects (VSDs). The period of percutaneous valve implantation is just beginning, and the next few years may bring about advances in miniaturized valve distribution methods to allow insertion in smaller children.Conclusions: Completely prepared CATHETERIZATION laboratory, surgical holdup, and extracorporeal membrane oxygenation support capabilities must be accessible at any center to achieve interventional CARDIAC CATHETERIZATION. Additional understanding of normal history of interventions more than 2 decade post process, novel strategies and methods will certainly lead to an increase in the methods for managing of congenital heart disease.

Background: Local vascular COMPLICATIONS in PEDIATRICs undergoing congenital CARDIAC CATHETERIZATION are consistently reported to be the commonest regardless of the access type and side. Methods: This is a retrospective study with data collection of multidetector computed tomography studies performed between 2016 and 2019 from 3 large CARDIAC centers in our country. Results: Totally, 190 patients who required both arterial and venous access sites were randomization into Group I or the planned ipsilateral group (the planned insertion of both arterial and venous sheaths in the same limb), Group II or the planned contralateral group (the planned insertion of arterial and venous sheaths in different limbs), and Group III or the unplanned group (unplanned vascular access sidedness after the failure of initial randomization). The incidence and types of local vascular COMPLICATIONS during the hospital stay were recorded. Patients with the unplanned vascular access site had a higher incidence of local vascular COMPLICATIONS, longer hospital stays, with higher needs for heparin and thrombolytic therapy than patients with the planned vascular access site. Patients with a systematically planned contralateral access site showed a lower incidence of arterial thrombosis, delayed capillary refilling time, and arteriovenous fistula, as well as lower needs for heparin and thrombolytic administration than patients with the planned ipsilateral vascular access site. Conclusions: Systematic planned contralateral vascular access in patients who undergo congenital heart disease CATHETERIZATION requiring both arterial and venous sheaths is associated with a lower incidence of vascular COMPLICATIONS, especially in patients weighing less than 10 kg.

Introduction: Bleeding, hematoma and cyanosis in the arterial catheter site are considered the most important COMPLICATIONS after coronary artery angiography. A method in which homeostasis can result faster and patient can walk sooner should be found. Therefore, this study aimed to compare two methods of sandbags and transparent film dressings to reduce COMPLICATIONS after coronary artery angiography.Methods: This quasi-experimental study was conducted on 80 eligible patients at Shafa Hospital in Kerman, Iran. After angiography, the patients were randomly divided into two groups (n=40), a transparent film dressing and traditional dressing with sand bags groups. Transparent Talc and ECG paper, a 10-cm ruler, in the range of zero to ten, and the blood-soaked film weight (weight before and after angiography), were respectively used to measure cyanosis, the pain intensity and the amount of bleeding.Results: No bleeding was observed in patients using transparent film dressing. After coronary angiography, the intensity of back pain and groin pain in patients using traditional dressing with sand bags was higher than in those using the transparent film dressing. Cyanosis was the same in both groups.Conclusion: Transparent film dressing is advised because of its impact of on reduction of COMPLICATIONS after angiography, and also flexibility, semi-permeability, convenience, simplicity of usage and visibility.

Objectives: This prospective study was designed with the aim to evaluate the prevalence and risk factors of arterial and venous COMPLICATIONS among children and adolescents during CARDIAC CATHETERIZATION. Methods: All patients younger than 18 yearswhounderwent CARDIAC CATHETERIZATION from April 2016 to April 2017 were consecutively enrolled in this study. Results: Atotal of 179 vascular accesses were performed, andmost(70%) cases were interventional procedures. Totally 17 (14%) arterial and 16 (13%) venous events occurred, while 4% and 5% of them, respectively, were more serious. Half of the patients who underwent axillary artery access developed major or minor trauma, and these subtracted from total events of artery accesses, only 9% of femoral arteries developed minor or major COMPLICATIONS. The more serious arterial COMPLICATIONS were dissection, pseudo-aneurysm and fistula whereas in venous access they were pseudo-aneurysm and thrombosis. Serious and non-serious COMPLICATIONS considered together, the mean age of those without complication was 1. 9 3. 6 years and in complicated group it was 1. 7 2. 6 years (P = 0. 33), and the mean weight of non-complicated cases was 9. 27  7. 9 kg and 8. 51  8. 12 kg in the complicated group with no significant difference (P = 0. 41), whereas the incidence of more serious vascular COMPLICATIONS was highest among patients younger than 1 year of age, and less than 9 kilograms. 23% of the cases who underwent more than 3 tries for arterial and 100% for venous access showed the COMPLICATIONS. Also few arterial tries resulted in unintentional venous COMPLICATIONS and vice versa. None of the cases needed surgical or interventional therapy. Conclusions: Our study showed that venous COMPLICATIONS are as high as arterial COMPLICATIONS, although most of them are selflimited.

Background: The most important complication following CARDIAC CATHETERIZATION required urgent therapeutic management is vessel obstruction and arterial thrombosis. The morbidity following this complication can be decreased by surgery intervention and/or thrombolytic drugs.Objectives: In this study we evaluated the effects of ranitidine and hydrocortisone on PEDIATRIC patients with congenital heart diseases who suffered from femoral artery obstruction following CARDIAC CATHETERIZATION on decreasing the events after streptokinase administration.Materials and Methods: This semi experimental study was conducted on 47 patients among 600 cases who underwent CARDIAC CATHETERIZATION from April 2002 to December 2011.The patients suffered from distal vessel obstruction following CARDIAC CATHETERIZATION with no response to surgery intervention, were enrolled and divided in two groups. Streptokinase was administrated in both groups. Patients in group 2 (25 cases), received ranitidine and hydrocortisone before streptokinase administration. In group 1 (22 cases), the loading dose of streptokinase was 2000IU/kg/ in 20-30 minutes/ infusion and thereafter streptokinase was administrated 1000 IU /kg/hour. In group 2, the loading dose was 3000IU/kg in 20-30 minutes /infusion and 1500 IU/kg/hour as maintenance dose. The infusion dose of streptokinase was decreased and then terminated in 2-3 hours by the time arterial pulse was detected by pulse oximetry.Results: There were 13 (59, 1%) male and 9 (40.9%) female patients in group 1. In group 2, there were 15 (60%) male and 10 (40%) female cases (P=0.949). Patients in both groups were matched well regarding age, body weight, height and the duration of streptokinase infusion (P dlt;0.05). The incidence of hematoma was higher in group 1 than group 2 (P=0.032). the patients of Group 1 required more blood transfusion than group 2 because the incidence of bleeding was more in the first group (P=0.042). 12 patients in group 1 required fresh frozen plasma transfusion versus 4 patients in group 2 (P=0.049). Local oozing was detected more in group 1 (P=0.042). Significant bleeding was occurred in 6 cases in group 1; however this event did not occurrin any patients in group 2 (P=0.007). Although 4 patients in group 1 suffered from anaphylactic shock after streptokinase administration but no patients in group 2 did. (P=0.041).Conclusions: Based on the results of this study, we concluded that streptokinase was able to remove the vessel thrombosis at the site of CARDIAC CATHETERIZATION and ranitidine and hydrocortisone administration before streptokinase may be effective in order to reduce the COMPLICATIONS related to thrombolytic drugs; however the experience of the performer is an issue of concern in this matter.

Introduction: The goal of this study was to elucidate harmful COMPLICATIONS of intraoperative hyperglycemia following children CARDIAC surgery and benefits of insulin administration for accurate blood sugar controlling. Methods: this study is a Randomized clinical trial. We conducted this study in the operating room of shahid madani hospital. Fifty patients who were children under 12 years old undergone CARDIAC surgery using cardiopulmonary bypass (CPB). Intraoperative insulin infusion was administered intravenously targeting blood sugar levels of 110-140 mg/dL. Blood sugar and arterial blood gas (ABG) were measured every 30 min during operation. Results: Inotropes were used less in the study than the placebo group during surgery. The means of hospitalization and extubation time were more in the placebo group than the study group (P = 0. 03) and (P = 0. 005), respectively. However, the mean time of hospitalization in the ICU ward did not differ significantly between the two groups. Conclusion: Hyperglycemia has a relation with long time of intubation and hospitalization in ICU. These findings suggest the positive effect of accurate blood sugar control on reducing complication and hospitalization time in children undergoing CARDIAC surgery.

Background: CARDIAC CATHETERIZATION is a useful method for determining the anatomy and pressure in CARDIAC vessels and chambers. The use of anesthesia methods with minimal hemodynamic and respiratory effects can increase diagnostic accuracy. Objectives: Since there are a few exclusive PEDIATRIC angiography centers, scarce studies have been done in this area. Accordingly, this study determined the effects of intermittent positive pressure ventilation (IPPV) versus spontaneous ventilation on cardiorespiratory parameters in less than one-year-old PEDIATRIC patients undergoing angiography with general anesthesia. Methods: In this interventional study that was performed as a double-blind, randomized clinical trial, 60 children younger than one year were enrolled. The pulmonary, renal, hepatic, and metabolic background diseases, previous CARDIAC and thoracic surgery, requiring over two ketamine doses, and receiving sedative or anti-convulsant therapeutics were excluded. The patients were randomly assigned to two groups, including IPPV and spontaneous ventilation. Their vital signs were also recorded before and after anesthesia induction and needling, as well as during measurements of pulmonary parameters and systemic blood pressure. All measurements were done by a single operator using the same device for each variable. Results: It was seen that SPO2, as well as PCO2 after anesthesia had significant alterations among the study variables. Nausea and vomiting, pain, and agitation were not different across the groups (P-value > 0. 05). Conclusions: In this study, we found that IPPV and spontaneous ventilation have the same effects on respiration. Both techniques can be used in children with different cardiovascular CATHETERIZATION conditions to increase accuracy and reduce alterations in cardiopulmonary parameters.