DIAGNOSTIC CARDIAC CATHETERIZATION IN PATIENTS OF TETRALOGY OF FALLOT - PROGRADE VS. RETROGRADE APPROACH

Abstract

Objective: Diagnostic cardiac catheterization for Tetralogy of Fallot (TOF) is still
commonly practiced in our country. Aim of this study was to compare results and
complications of prograde/antegrade and retrograde approach in diagnostic
catheterizations of TOF.
Methodology: This prospective comparative study was conducted at AFIC/NIHD
Rawalpindi from December 2010 to June 2012. 269 consecutive patients who
underwent diagnostic cardiac catheterization for TOF were included and divided
in three groups. Group A: Prograde study planned, Group B: both venous and
arterial accesses were electively obtained at the start and group C, where
retrograde study was planned. Group A & C were subdivided: Group Aa, study
completed in prograde manner and group Ab where arterial line was
subsequently placed for completion of study. Group Ca, study completed in
retrograde approach and group Cb where venous line was subsequently placed.
Data analysis was computer based using SPSS 17 version.
Results: Total 269 patients with mean age of 7.7 years and including 169 males.
Group A included 200 cases (Aa 129 & Ab 71), group B: 45 cases and group C
included 24 cases (Ca18 & Cb 6). Systemic complications included 9 episodes
of hyper-cyanotic spells (Gp Aa 3, Ab 4, B2), transient Arrhythmias (Aa 1, 2 Ab,
2B) and a transient cardiac arrest (Gp B). The group percentage of local vascular
complication in group B as 22.2%, group C 12.5%, group Ab 8.4% and none in
group Aa.
Conclusion: Prograde cardiac catheterization for TOF is safe and preferable
option in most cases.