Complications of pediatric cardiac catheterization and system of catheterization laboratories minimizing complications--a Japanese multicenter survey.

BACKGROUND: Pediatric cardiac catheterization is sometimes associated with serious complications. However, there are no data regarding the organization of pediatric cardiac catheterization laboratories to minimize complications.
OBJECTIVES: The aim of this study was to determine the current organization of pediatric cardiac catheterization laboratories with regard to patient safety in Japan. METHODS AND
RESULTS: We sent questionnaires to 105 institutions and obtained data from 82. Major complications requiring surgical therapy or death occurred in 22 institutes (27%). The incidence of major complications did not relate to the number of procedures performed. The procedures were performed without written informed consent in 21% of all institutions. The time to inform about the procedures was within 30 min in 43 institutes (52%). A pre-procedure meeting was held in 56 institutions (68%). The anesthetist attended the diagnostic procedures in 23% and the therapeutic procedures in 53%. The drugs and defibrillator for resuscitation were available in almost all institutions, but a pacemaker was not in 23 institutions (28%). The procedures were performed under the "back-up" of cardiovascular surgeons in 38 institutions (46%).
CONCLUSION: There are still large numbers of institutions in Japan, which need much improvement in the organization of pediatric cardiac catheterization laboratories as an aspect of patient safety.