Trends in preoperative cardiac catheterisation in congenital heart disease

Abstract

Objective: To establish trends in preoperative diagnostic cardiac catheterisation in congenital heart disease (CHD) Design: Retrospective analysis of performance of catheterisation preoperatively for 1 st, 2nd, 3rd and 4th operation for significant and complex CHD. Setting: Regional hospital providing CHD diagnostic and follow-up services for all Malta. Patients: Patients operated for CHD between 1947 and 1994. Main outcome measures: Whether or not preoperative catheterisation was performed. Results: 651 operations were carried out for CHD between 1947-1994. The proportion of patients undergoing cardiac catheterisation prior to surgery has declined (p=0.0004). Further analysis showed that this trend was due to a reduction in the proportion of patients undergoing catheterisation prior to 1 st operation for significant CHD (p<O.OOOl). This group constituted 75% of all operations. No trends were found in other types of operations. Conclusions: Echocardiography , a non-invasive technique, has supplanted cardiac catheterisation as the primary diagnostic tool prior to 1 st operation for significant CHD. However, catheterisation maintains a role for investigation prior to other operations for CHD.