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Published in: World Journal of Pediatrics 4/2018

01-08-2018 | Original Article

Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients

Authors: Parth Bhatt, Achint Patel, Varun Kumar, Anusha Lekshminarayanan, Viranchi Patel, Srilatha Alapati, Zeenia Cyrus Billimoria

Published in: World Journal of Pediatrics | Issue 4/2018

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Abstract

Background

We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients.

Methods

We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project.

Results

6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87, P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89, P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42, P < 0.001) were lower as compared to the 1st tertile of hospital volume.

Conclusion

Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.
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Literature
2.
go back to reference Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K, Amplatzer I. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol. 2002;39:1836–44.CrossRefPubMed Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K, Amplatzer I. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol. 2002;39:1836–44.CrossRefPubMed
7.
go back to reference Badheka AO, Patel NJ, Grover P, Singh V, Patel N, Arora S, et al. Impact of annual operator and institutional volume on percutaneous coronary intervention outcomes: a 5-year United States experience (2005–2009). Circulation. 2014;130:1392–406.CrossRefPubMed Badheka AO, Patel NJ, Grover P, Singh V, Patel N, Arora S, et al. Impact of annual operator and institutional volume on percutaneous coronary intervention outcomes: a 5-year United States experience (2005–2009). Circulation. 2014;130:1392–406.CrossRefPubMed
9.
go back to reference Grohmann J, Wildberg C, Zartner P, Abu-Tair T, Tarusinov G, Kitzmuller E, et al. Multicenter midterm follow-up results using the gore septal occluder for atrial septal defect closure in pediatric patients. Catheter Cardiovasc Interv. 2017;89:e226–32.CrossRefPubMed Grohmann J, Wildberg C, Zartner P, Abu-Tair T, Tarusinov G, Kitzmuller E, et al. Multicenter midterm follow-up results using the gore septal occluder for atrial septal defect closure in pediatric patients. Catheter Cardiovasc Interv. 2017;89:e226–32.CrossRefPubMed
10.
go back to reference Tanghoj G, Odermarsky M, Naumburg E, Liuba P. Early complications after percutaneous closure of atrial septal defect in infants with procedural weight less than 15 kg. Pediatr Cardiol. 2017;38:255–63.CrossRefPubMed Tanghoj G, Odermarsky M, Naumburg E, Liuba P. Early complications after percutaneous closure of atrial septal defect in infants with procedural weight less than 15 kg. Pediatr Cardiol. 2017;38:255–63.CrossRefPubMed
11.
go back to reference Wyss Y, Quandt D, Weber R, Stiasny B, Weber B, Knirsch W, et al. Interventional closure of secundum type atrial septal defects in infants less than 10 kilograms: indications and procedural outcome. J Interv Cardiol. 2016;29:646–53.CrossRefPubMed Wyss Y, Quandt D, Weber R, Stiasny B, Weber B, Knirsch W, et al. Interventional closure of secundum type atrial septal defects in infants less than 10 kilograms: indications and procedural outcome. J Interv Cardiol. 2016;29:646–53.CrossRefPubMed
12.
go back to reference Behjati-Ardakani M, Golshan M, Akhavan-Karbasi S, Hosseini SM, Behjati-Ardakani MA, Sarebanhassanabadi M. The clinical course of patients with atrial septal defects. Iran J Pediatr. 2016;26:e4649.CrossRefPubMedPubMedCentral Behjati-Ardakani M, Golshan M, Akhavan-Karbasi S, Hosseini SM, Behjati-Ardakani MA, Sarebanhassanabadi M. The clinical course of patients with atrial septal defects. Iran J Pediatr. 2016;26:e4649.CrossRefPubMedPubMedCentral
13.
go back to reference Knepp MD, Rocchini AP, Lloyd TR, Aiyagari RM. Long-term follow up of secundum atrial septal defect closure with the amplatzer septal occluder. Congenit Heart Dis. 2010;5:32–7.CrossRefPubMed Knepp MD, Rocchini AP, Lloyd TR, Aiyagari RM. Long-term follow up of secundum atrial septal defect closure with the amplatzer septal occluder. Congenit Heart Dis. 2010;5:32–7.CrossRefPubMed
14.
go back to reference Feltes TF, Bacha E, Beekman RH 3rd, Cheatham JP, Feinstein JA, Gomes AS, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2607–52.CrossRefPubMed Feltes TF, Bacha E, Beekman RH 3rd, Cheatham JP, Feinstein JA, Gomes AS, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2607–52.CrossRefPubMed
15.
go back to reference Ooi YK, Kelleman M, Ehrlich A, Glanville M, Porter A, Kim D, et al. Transcatheter versus surgical closure of atrial septal defects in children: a value comparison. JACC Cardiovasc Interv. 2016;9:79–86.CrossRefPubMed Ooi YK, Kelleman M, Ehrlich A, Glanville M, Porter A, Kim D, et al. Transcatheter versus surgical closure of atrial septal defects in children: a value comparison. JACC Cardiovasc Interv. 2016;9:79–86.CrossRefPubMed
16.
go back to reference Moore JW, Vincent RN, Beekman RH, Benson L, Bergersen L, Holzer R, et al. Procedural results and safety of common interventional procedures in congenital heart disease: initial report from the national cardiovascular data registry. J Am Coll Cardiol. 2014;64:2439–51.CrossRefPubMed Moore JW, Vincent RN, Beekman RH, Benson L, Bergersen L, Holzer R, et al. Procedural results and safety of common interventional procedures in congenital heart disease: initial report from the national cardiovascular data registry. J Am Coll Cardiol. 2014;64:2439–51.CrossRefPubMed
17.
go back to reference Opotowsky AR, Landzberg MJ, Kimmel SE, Webb GD. Percutaneous closure of patent foramen ovale and atrial septal defect in adults: the impact of clinical variables and hospital procedure volume on in-hospital adverse events. Am Heart J. 2009;157:867–74.CrossRefPubMed Opotowsky AR, Landzberg MJ, Kimmel SE, Webb GD. Percutaneous closure of patent foramen ovale and atrial septal defect in adults: the impact of clinical variables and hospital procedure volume on in-hospital adverse events. Am Heart J. 2009;157:867–74.CrossRefPubMed
18.
go back to reference Singh V, Badheka AO, Patel NJ, Chothani A, Mehta K, Arora S, et al. Influence of hospital volume on outcomes of percutaneous atrial septal defect and patent foramen ovale closure: a 10-years US perspective. Catheter Cardiovasc Interv. 2015;85:1073–81.CrossRefPubMed Singh V, Badheka AO, Patel NJ, Chothani A, Mehta K, Arora S, et al. Influence of hospital volume on outcomes of percutaneous atrial septal defect and patent foramen ovale closure: a 10-years US perspective. Catheter Cardiovasc Interv. 2015;85:1073–81.CrossRefPubMed
19.
go back to reference Armsby LB, Vincent RN, Foerster SR, Holzer RJ, Moore JW, Marshall AC, et al. Task force 3: pediatric cardiology fellowship training in cardiac catheterization. SPCTPD/ACC/AAP/AHA. Circulation. 2015;132:e68–74.CrossRefPubMed Armsby LB, Vincent RN, Foerster SR, Holzer RJ, Moore JW, Marshall AC, et al. Task force 3: pediatric cardiology fellowship training in cardiac catheterization. SPCTPD/ACC/AAP/AHA. Circulation. 2015;132:e68–74.CrossRefPubMed
20.
go back to reference American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures), King SB 3rd, Aversano T, Ballard WL, Beekman RH 3rd, Cowley MJ, et al. ACCF/AHA/SCAI 2007 update of the Clinical Competence Statement on Cardiac Interventional Procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures). Circulation. 2007;116:98–124. American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures), King SB 3rd, Aversano T, Ballard WL, Beekman RH 3rd, Cowley MJ, et al. ACCF/AHA/SCAI 2007 update of the Clinical Competence Statement on Cardiac Interventional Procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures). Circulation. 2007;116:98–124.
Metadata
Title
Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients
Authors
Parth Bhatt
Achint Patel
Varun Kumar
Anusha Lekshminarayanan
Viranchi Patel
Srilatha Alapati
Zeenia Cyrus Billimoria
Publication date
01-08-2018
Publisher
Childrens Hospital, Zhejiang University School of Medicine
Published in
World Journal of Pediatrics / Issue 4/2018
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-018-0120-3

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