{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:43:25Z","timestamp":1776062605863,"version":"3.50.1"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergency cardiac catheterizations (ECC) during off-hours are high risk due to limited staffing and resources. To date, no systematic data are available on the outcomes of such emergent procedures for congenital heart disease (CHD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To the best of our knowledge, this study is among the first to systematically evaluate outcomes, procedural characteristics, and multidisciplinary involvement in off-hours ECC among patients with CHD<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed all ECC performed during evenings and nights over two and half years at a single tertiary center. Data included demographics, indications, interventions, staffing, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between January 2023 and November 2025, a total of 2,050 procedures were performed; of these, 37 (1.8%) were emergent off-hours cases. Median age was 25 days (range: 1 day\u201314 years); median weight was 3.9\u2005kg (range: 2\u201350\u2005kg). Indications included critical cyanosis (40.5%), cardiogenic shock (19%), postoperative instability (37.8%), and interventional complications (2.7%). Interventions included Rashkind atrioseptostomy, pulmonary\/aortic balloon angioplasty, shunt, pulmonary and coarctation stenting, and postoperative rescue procedures, accounting for 89% of cases. All ECCs were performed by a single interventionalist. Nursing staff support was required in 48% of performed interventions, primarily those involving stenting and dilation. Rashkind-guided echocardiography was performed by anesthesiology (n\u2009=\u20097). The surgical team was on-site in 40% of cases. All patients who underwent intervention showed clinical improvement; ECMO was avoided in four cases and weaned in two. No early complications were observed. One late femoral arteriovenous fistula required surgical revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emergent off-hours catheterizations in CHD can achieve favorable outcomes when performed by a skilled multidisciplinary team. Success depends not only on physician expertise but also on institutional readiness, effective organization, and seamless team coordination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1752520","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:44:56Z","timestamp":1776059096000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond daylight: emergent cardiac catheterization in congenital heart disease during evenings and nights: clinical demand and logistical realities"],"prefix":"10.3389","volume":"13","author":[{"given":"Nathalie","family":"Mini","sequence":"first","affiliation":[{"name":"Cardiac Catheterization Laboratories, German Paediatric Heart Center, University Hospital Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin B. E.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratories, German Paediatric Heart Center, University Hospital Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehrenfried","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boulos","family":"Asfour","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, German Pediatric Heart Centre, University Hospital Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Mikus","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1007\/s00246-013-0752-y","article-title":"Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease","volume":"35","author":"Lin","year":"2014","journal-title":"Pediatr Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1002\/pd.4438","article-title":"Outcomes of critical congenital heart disease requiring emergent neonatal cardiac intervention","volume":"34","author":"Pruetz","year":"2014","journal-title":"Prenat Diagn"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1016\/j.jcin.2019.07.017","article-title":"On- versus off-hours presentation and mortality of ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention","volume":"12","author":"Lattuca","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"B4","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1017\/S1047951124036606","article-title":"Association between procedure duration and adverse events in congenital cardiac catheterization","volume":"35","author":"Yeh","year":"2025","journal-title":"Cardiol Young"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.3390\/healthcare13121412","article-title":"The weekend effect on in-hospital mortality\u2014first 13-year retrospective observational study in Slovakia","volume":"13","author":"Hrub\u00e1","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"E185","DOI":"10.25270\/jic\/22.00367","article-title":"Off-hours presentation, door-to-balloon time, and clinical outcomes in patients referred for primary percutaneous coronary intervention","volume":"35","author":"Rashid","year":"2023","journal-title":"J Invasive Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3046","DOI":"10.1093\/eurheartj\/ehs261","article-title":"Mortality outcome of out-of-hours primary percutaneous coronary intervention in the current era","volume":"33","author":"Noman","year":"2012","journal-title":"Eur Heart J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e009562","DOI":"10.1161\/CIRCINTERVENTIONS.120.009562","article-title":"Effects of on-hours versus off-hours admission on outcome in patients with myocardial infarction and cardiogenic shock: results from the CULPRIT-SHOCK trial","volume":"13","author":"Sag","year":"2020","journal-title":"Circ: Cardiovasc Interventions"},{"key":"B9","doi-asserted-by":"publisher","first-page":"566","DOI":"10.20452\/pamw.15579","article-title":"Day versus night in the catheterization laboratory: all the same","volume":"130","author":"Mercado","year":"2020","journal-title":"Pol Arch Intern Med"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1752520\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:44:56Z","timestamp":1776059096000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1752520\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":9,"alternative-id":["10.3389\/fcvm.2026.1752520"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1752520","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"1752520"}}