Risk Factors for Major Early Adverse Events Related to Cardiac Catheterization in Children and Young Adults With Pulmonary Hypertension: An Analysis of Data From the IMPACT (Improving Adult and Congenital Treatment) Registry

Figures

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  Figure 1. Study population. BAV indicates balloon aortic valvuloplasty; BPV, balloon pulmonary valvuloplasty; ECMO, extracorporeal membrane oxygenation; PA, pulmonary artery; PVRI, indexed pulmonary vascular resistance; Qp:Qs, ratio of pulmonary/systemic blood flow; and VAD, ventricular assist device.

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  Figure 2. Risk factors for catastrophic adverse outcome. The figure is a forest plot that depicts the association between individual prespecified patient‐ and procedure‐level factors potentially associated with the risk of death, cardiac arrest, or initiation of extracorporeal membrane oxygenation after catheterization in the study population. Odds ratios (ORs; blue diamonds) and 95% confidence intervals (CIs; brackets) are depicted from the mixed‐effects multivariable model. For factors associated with increased risk of the composite outcome, the point estimate and 95% CI are completely to the right of the dashed line, marking an OR of 1. For factors associated with decreased risk of the composite outcome, the point estimate and 95% CI are entirely to the left of the dashed line. Factors with significant association to catastrophic adverse outcomes are boldfaced. AE indicated adverse event; APAH‐CHD, pulmonary hypertension associated with congenital heart disease; CT, computed tomography; and IPAH, primary pulmonary hypertension.

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  Figure 3. Relationship between hospital annual catheterization volume and annual volume of catheterizations performed in patients with pulmonary hypertension. The figure is a scatter plot of the average procedural volume for each hospital during the study period (each blue circle represents a contributing hospital). The total catheterization volume for each hospital is depicted on the x axis, and the number of cases performed per year in patients with pulmonary hypertension is depicted on the y axis. A line of best fit is plotted as well (red). Catheterizations performed in patients with pulmonary hypertension (PH) are a consistent proportion of total cases (P<0.0001 and r 2=0.86). PH catheterizations=0.15×total catheterizations−15.