Postoperative assessment of residual defects following cardiac surgery in infants and children. I. Rationale and methodology

Cardiac catheterization is a highly sophisticated method of gathering hemodynamic, electrophysiological and anatomical data. The primary purposes of cardiac catheterization and angiocardiography are to delineate the hemodynamic status and the details of the intracardiac anatomy in order to decide whether surgical repair is indicated and, if so, what is the best approach to such repair. The authors have come to realize that evaluation following surgical repair is equally necessary. Open heart surgery often dramatically alters the significance and nature of the physical and laboratory findings. It is usually beneficial to the patient to have a more exact delineation of the results of surgery, so that more accurate advice might be given in terms of the need for future clinical visits and other management. They recommend cardiac catheterization following all open heart surgery in infants and children unless they obviously have no residual defects. For this study, to minimize the possibility of introducing bias into the data, every effort was made to catheterize all patients who had undergone heart surgery since January 1, 1968 without regard to clinical findings. A total of 537 patients were operated on during this time and 472 of them survived the operation; 300 (64%) of these patients have been recatheterized. No serious complications have occurred in this group.