329 Complications of cardiac catheterization in congenital heart disease, 30 years of experience. A new risk-adjusted score Complicaciones del cateterismo cardiaco en cardiopatías congénitas, 30 años de experiencia. Un nuevo score ajustado al riesgo Ricardo Gamboa 1 *, Alfredo Bravo 2 , Jesús Damsky-Barbosa 3 , Eduardo Benítez 4 , Pablo Pedroni 5 , Martín Roth 6 , Francisco Pedro-Mollón 7 and Estefanía Solari 8 1 Area of Pediatric Cardiology and Adult Congenital Heart Diseases, Hemodynamics Department, Hospital de Alta Complejidad El Cruce, Florencio Varela, Buenos Aires; 2 Hemodynamics Department, Instituto Cardiovascular Villa Mercedes, San Luis; 3 Department of Pediatric Cardiology and Hemodynamics, Hospital Pedro de Elizalde, Buenos Aires; 4 Cardiology Department, Policlínico Regional de Villa Mercedes, San Luis; 5 Hemodynamics Department, Hospital el Cruce, Florencio Varela, Buenos Aires; 6 Anesthesiology Department, Hospital Garrahan, Ciudad Autónoma de Buenos Aires; 7 Hemodynamics Department, Clínica Guemes, Luján, Buenos Aires; 8 Institute of Administrative Research, Faculty of Economic Sciences, Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina ORIGINAL RESEARCH ARTICLE Abstract Objective: to present a risk-adjusted score of complications during cardiac catheterization in congenital heart dis- ease. Design: observational, analytic, and ambispective of 3.504 cases. The data analyzed included age, heart disease, type of procedure, major and minor complications. Methods: 3.504 procedures performed between October 1987 and May 2019. The variables were age, heart disease, procedure and clinical stage. Each patient was categorized as low risk 5 to 7 points, moderate risk 8 to 11 points, and high risk 12 to 22 points. The score was validated using the Hosmer-Lemeshow test and the ROC curve (Receiver Operating Characteristic). Results: complications 177 (5%) 66 major (1.9%) and 111 minor (3.1%). Mortality was 0.4% (15 patients). The low-risk group (n = 825) had 1.5% complications; moderate risk (n = 2,221) 4.9%; high risk (n: 458) 12% (p < 0.001). The analysis of the retrospective data (n = 2953) was validated with prospective (n = 551) using the Hosmer-Lemeshow test, showed that the predicted values are similar to those observed. Conclusions: Complica- tions continue to occur despite the evolution of the technique. The score was useful for stratifying patients and knowing the probability of complication before the procedure. Keywords: Complications. Diagnostic and interventional catheterization. Congenital heart disease. Resumen Objetivo: Presentar un score ajustado al riesgo de complicaciones durante el cateterismo cardiaco en cardiopatías congénitas. Diseño: Observacional, analítico y ambispectivo de 3,504 casos. Se incluyeron edad, cardiopatía, procedimiento, complicacio- nes mayores y menores. Métodos: 3,504 procedimientos realizados entre octubre de 1987 y mayo de 2019. Variables inde- pendientes: edad, cardiopatía, procedimiento y estadio clínico. Se categorizó como bajo riesgo 5 a 7 puntos, moderado riesgo 8 a 11 puntos y alto riesgo 12 a 22 puntos. El score fue validado mediante la prueba de Hosmer-Lemeshow y la curva ROC (receiver operating characteristic). Resultados: Las complicaciones fueron 177 (5%), 66 mayores (1.9%) y 111 menores (3.1%). Available online: 24-07-2023 Arch Cardiol Mex (Eng). 2023;93(2):329-336 www.archivoscardiologia.com Date of reception: 19-10-2021 Date of acceptance: 21-06-2022 DOI: 10.24875/ACME.M23000394 2604-7063 / © 2022 Instituto Nacional de Cardiología Ignacio Chávez. Published by Permanyer. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). *Correspondence: Ricardo Gamboa E-mail: rgamboa33@yahoo.com.ar