Cardiac catheterization plays a major role in the success of our Congenital Cardiovascular Disease Program. Many cases of congenital heart disease are treated solely by intervention in the catheterization laboratory without need for surgery. Interventional catheterization is also employed to improve surgical results and to rescue patients who are struggling after complex surgeries. Furthermore, diagnostic catheterization is essential to provide precise diagnosis in cases when other imaging modalities are not definitive.
At Rady Children’s Hospital-San Diego, we have been performing all types of cardiac catheterization for more 30 years. Our two interventional cardiologists were trained by one of the founders of interventional cardiac catheterization, Dr. Charles Mullins. Both have more than 15 years of experience and are very active in research and publications. The catheterization laboratory staff consists of four very experienced radiology technicians and two senior ICU nurses. Our team provides extraordinary care for our patients, and is available 24 hours a day/seven days a week.
The cardiac catheterization laboratory provides care for infants, children and adults with congenital and acquired heart diseases. We perform approximately 500 procedures annually, and our laboratory is classified by the National Cardiovascular Data Registry as a high-volume congenital heart disease center. Three quarters of our procedures are interventional. The table below compares procedure success and complication rates at Rady Children’s with national norms. Our program consistently outperforms or performs as well as other programs in the United States.
|Type of Case||# of cases (2009-2014)||Rady Children’s success rate||national success rate||Rady Children’s complication rate||national complication rate|
|Coarctation Aorta Stent1||67||100%||99%||0%||1.2%|
|Pulmonary Artery Angioplasty/Stent1||432||99%||99%||0.9%||1.2%|
|Melody Valve Implant2||64||100%||96.7%||0%||6.1%|
|Infant (1- 12 mo) Catheterization1||670||100%||100%||0%||6.1%|
Procedure success rates and major or serious adverse event rates from 1 NCDR IMPACT Registry Data or 2 Melody Sentinel FDA Study Data.
The Electrophysiology (EP) program at Rady Children’s was started 21 years ago, in 1993. Since then, it has developed into one of the top-performing programs in the United States for catheter ablation outcomes, as well as for clinical and translational research efforts.
The EP team is lead by Dr. James Perry, who performed one of the first pediatric catheter ablations in Houston in late 1989. The program has an experienced group of nurses, cath lab technologists, anesthesiologists and surgeons to insure that EP care is both exceptional on a day-to-day basis and also at the cutting edge of innovation. The group recently implanted a long-term arrhythmia monitoring device in the youngest patient in the U.S. at the time to receive one. Clinically, we have a large volume of patients with “channelopathies,” including long QT Syndrome. Dr. Perry is on the medical advisory board of the SADS (sudden arrhythmia death syndrome) Foundation and recently stepped down from a long tenure on the board of the Adult Congenital Heart Association.
The EP lab aspect of the program is expanding from its current volume of 110-120 cases per year with the addition of another electrophysiologist in 2015. Our outcomes are outstanding, exceeding national published data, and are provided in an environment of personalized care and expertise. The program participates in a number of national multicenter studies and has provided co-authorship for the guidelines of care for adult congenital heart patients with rhythm issues, asymptomatic Wolff-Parkinson-White patients and also the published standards for electrophysiology labs nationally.
The EP lab strives to provide the best care for EP assessments, catheter ablations, 3-dimensional mapping and pacemaker and ICD (defibrillator) implantations. The EP Program is also intimately involved in the care of our Hawaiian patients, in close collaboration with our colleagues at Kapi’olani Women and Children’s Hospital, Straub Clinic, Tripler Medical Center and Kaiser systems in Honolulu. We provide EP care in Honolulu four to five times each year, as part of a relationship dating back 19 years. Outcomes for EP procedures there have matched our successes in San Diego.
|long-term SVT ablation success||national success data||post-ablation SVT recurrence||national recurrence||AV block||national AV block|
|San Diego EP Lab (2009-2014)
|all SVT cases||98.9%||94-98%||2.2%||3-11.6%||0.0%||0-5%|
|AV node reentry||99.1%||90-99%||0.9%||0-6.5%||0.0%||0-1%|
|Hawaii EP Lab (late 2011-2014)
|all SVT cases||95.1%||94-98%||3.0%||3-11.6%||0.0%||0-5%|