SAFETY OF CONTRAST ADMINISTRATION IN COMPUTED TOMOGRAPHY ANGIOGRAPHY IN PEDIATRIC CONGENITAL HEART DISEASE: A 9-YEAR SINGLE CENTER COHORT OF 697 EXAMS
DOI:
https://doi.org/10.22551/Abstract
Pediatric cardiovascular congenital disease (CHD) diagnosis benefits greatly from thoracic computed tomography angiography (CTA), with an increasing number of referrals. The aim of this study was to evaluate the safety of CTA examinations in pediatric patients with congenital cardiovascular malformations. Materials and methods: A 9-year retrospective analysis of pediatric CTA reports was performed. 697 consecutive examinations were included, with recorded data consisting of demographic data of the patient and procedure-related information (cannulation type, site of venous access, type and volume of contrast agents, injection flow rate, dose and adverse events). Results: The median patient age was 199 days (interquartile range IQR [15,1714.5]), with a male: female ratio of 1.29. The most frequent peripheral cannulation site was the left antecubital fossa 265 cases (38.02%), and the most frequently used cannula size was 24-gauge (331 cases); a central line was used in 101 cases (14.49%). The flow rates for peripheral and central venous catheters were 0.3 to 5 mL/s, median 1.00, [0.8, 2.0] and 0.5 to 4 mL/s, median 0.9 [0.8, 1.0] respectively. Nine cases of contrast media extravasation (1.29%), four minor allergic reactions (0.6%), two cases of placement of the central venous catheter in the artery (0.29%), one case of air embolus (0.14 %) and one anaphylactic shock (0.14%) were recorded. Conclusions: In a single-center cohort of 697 pediatric CTAs for congenital heart disease over 9 years, complication rates related to contrast and venous access were low (extravasation ~1.3%; allergic reactions ~0.6%; anaphylaxis ~0.14%), all resolved favorably. Central line incidents were rare. The results support the safety of contrast administration in pediatric CTA of congenital heart disease, with the recommendation to verify the prescan and standardize protocols.
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