Complications of Cardiac Catheterization in Children with Congenital Heart Disease with and without Ranitidine and Hydrocortisone

Background and Objective: Cardiac catheterization constitutes an essential method for diagnosis in cardiology. In addition to diagnosis, it is largely applied in electrophysiological studies of the heart, post-surgical follow-up and cardiac interventions. Similar to any other aggressive diagnostic technique, cardiac catheterization may entail certain complications. The objective of the present study is to determine complications of cardiac catheterization in children with congenital heart diseases with and without ranitidine and hydrocortisone. Method: This is a clinical trial study on 400 children with congenital heart diseases who underwent cardiac catheterization in Ali Asghar and Ali-ebne Abitaleb Hospitals of Zahedan from March 2005 to February 2012. The children were classified into two groups. All patients underwent routine tests and para clinical procedures (Electrocardiography, Chest X-Ray, and Echocardiography) before cardiac catheterization and received premedication one hour before the procedure. The premedication consisted of morphine or promethazine for cyanotic patients and promethazine and pethedine for all other patients. All patients underwent cardiac catheterization by a pediatric cardiologist. After the procedure, all children were admitted to the hospital for 48 hours to monitor complications. Data were obtained from medical records using a specifically devised questionnaire, and analyzed on SPSS software version 17. Results: Complications occurred in 15.5% of our patients, with 5 patients (1.25% of total) experiencing a major, and 57 patients (14.25% of total) experiencing a minor complication. Vascular events (32 cases; 8%) and arrhythmia (8 cases; 2%) composed the majority of complications. Death occurred in two patients (0.5%). The major complications included death (2 cases), cardiac arrest with a successful resuscitation (1 case) and spell (2 cases). In the present study, we found no significant difference between the group receiving ranitidine and hydrocortisone and the group receiving neither to prefer one group over the other. Conclusion: The findings of the present study showed that the complications of cardiac catheterization is more or similar to other studies, except for small changes in minor complications and the fact that we observed no event of rupture or tamponade two serious complications. Moreover, our study demonstrates no significant difference between the two groups to indicate superiority for those receiving ranitidine and hydrocortisone, except for reaction to contrast.