Post-operative Catheterization Interventions at the Site of Surgery: An Application of the CRISP Scoring System
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates. A single-center, retrospective review of patients undergoing catheterization interventions within 6 weeks of cardiac surgery was conducted between Jan 2004 and Dec 2014. Patients who underwent dilation interventions across fresh suture lines (group 1) were compared to patients who underwent interventional procedures at other sites (group 2), and a CRISP score was calculated for all patients. Patients receiving only surveillance biopsies were excluded. Sixty-eight patients underwent 100 interventional procedures. Group 1 was composed of 44 patients receiving 64 interventions, while group 2 had 24 patients who underwent 36 interventions. Group 1 was comprised significantly more single ventricles and patients were smaller/younger. Group 1 had a significantly higher median CRISP score, but both groups were within Category 4. The rates of adverse events were similar between groups and comparable to predicted rates with the CRISP scoring system. Catheter-based interventions in the early post-operative period can be performed with no significant increase in the risk of serious adverse events when intervening across fresh suture lines. The CRISP scoring system can be a valuable tool in pre-procedural counseling of high-risk post-operative patients.
KeywordsCOMP-complications Pediatric Catheterization Intervention
Early post-operative cardiac interventional catheterization
Catheterization Risk in Pediatrics Score
Compliance with Ethical Standards
Conflict of interest
None of the authors have any relevant financial relationships to disclose.
- 12.Nicholson G et al. (2015) Transcatheter interventions across fresh suture lines in infants and children: an 8-year experience. Catheter Cardiovasc Interv 86:271–277Google Scholar
- 13.Nykanen DG, Forbes TJ, Du E, Divekar AA, Reeves JH, Hagler DJ, Fagan TE, Pedra CA, Fleming GA, Khan DM, Javois AJ, Gruenstein DH, Qureshi SA, Moore PM, Wax DH (2015) CRISP: Catheterization RISk Score for pediatrics: a report from the Congenital Cardiac Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv 87:302–309CrossRefPubMedGoogle Scholar
- 19.Bergesen L, Gauvreau K, Foerster SR et al (2011) Catheterization for congenital heart disease adjustment for risk method (CHARM). JACC: Cardiovascular Interv 4(9):1037–1046Google Scholar