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Objective: Cardiac catheterization in patients receiving extracorporeal life support (ECLS) has previously been shown to be safe and, in many cases, therapeutic. However, the influence of cardiac catheterization on clinical outcomes in this patient population has not been clearly defined.Methods: A single institution, retrospective review of all pediatric cardiac ECLS patients who underwent cardiac catheterization between January 2006 and September 2015 was performed.Results: Eighty-two interventional cardiac catheterization procedures were performed on 74 patients. Catheterization findings directly led to catheterization-based or surgical intervention in 54 (73%) patients. One (1.2%) catheterization-related complication occurred (pulmonary artery rupture), which ultimately resulted in death. Patients who underwent early catheterization (≤72 hours of ECLS initiation) required shorter total duration of ECLS than patients who underwent catheterization >72 hours after ECLS initiation (136 hours vs. 227 hours, P < 0.01). The groups experienced similar rates of interventions based on catheterization findings (72% early cath vs. 74% late cath, P = 0.81). Survival to hospital discharge was higher in the early catheterization group (74% vs. 51%, P = 0.04). In multivariate models adjusting for covariates, early catheterization was associated with a reduction in ECLS duration by approximately 150 hours (P < 0.01).Conclusions: Cardiac catheterization is safe in pediatric ECLS patients and an earlier catheterization is associated with shorter duration of ECLS and improved hospital survival. Diagnostic cardiac catheterization should be considered in patients who remain dependent on ECLS after several days of support. [ABSTRACT FROM AUTHOR]

Hypoplastic left heart syndrome is the most common diagnosis among infants requiring cardiac extracorporeal life support (ECLS) in the neonatal period, with more than half of patients experiencing an ECLS-related complication. We present a case of nearly obstructing neoaortic thrombus during ECLS occurring in the early postoperative period after modified Norwood palliation of hypoplastic left heart syndrome. Stasis within the neoaortic root due to the increased ventricular afterload associated with venoarterial ECLS may have potentiated this complication. Echocardiographic monitoring and early cardiac catheterization while on ECLS enabled prompt diagnosis and timely surgical correction. [ABSTRACT FROM AUTHOR]