Racial disparities were observed among pediatric cardiovascular patients receiving transcatheter interventions for both age at treatment and access to care, according to a recent study published in JACC: Advances. The analysis also found a greater proportion of minority patients being treated at low-volume centers.

Michael L. O'Byrne, MD, MSCE, et al., included 20,632 patients (age ≤18 years) from the ACC's IMPACT Registry who underwent transcatheter interventions between June 2016 and December 2022 – 34% for device closure of atrial septal defect (ASD); 48% for device closure of patent ductus arteriosus; 14% for balloon pulmonary valvuloplasty (BPV); and 5% for balloon aortic valvuloplasty (BAV). The authors evaluated associations between race-ethnicity and procedure-specific markers of disease severity, risk of adverse events and procedural volume by center.

Black, Hispanic and Asian patients were more likely to be older when undergoing ASD and BPV, and Hispanic patients tended to have more severe disease when undergoing BPV and BAV (p<0.05 for all). In addition, more Hispanic patients – and Black patients to a lesser extent – were treated at low-volume centers than high-volume centers (p<0.05 for all procedures).

While the analysis shows minority patients are older at the time of treatment, the authors were unable to determine whether this is due to a delay in diagnosis or referral to catheterization services. They also point out that current referral patterns may contribute to the disparities observed in centers of differing procedural volumes.

"Mitigation efforts should focus on the preprocedural care of these patients," they write. "Disparities in access to primary care, cardiology or referral from cardiology to the catheterization laboratory are all potential avenues for these efforts."