TY - JOUR
T1 - Upper-extremity venous access for children and adults in pediatric cardiac catheterization laboratory
AU - Randall, Jess T.
AU - Aldoss, Osamah
AU - Khan, Asra
AU - Challman, Melissa
AU - Hiremath, Gurumurthy
AU - Qureshi, Athar M.
AU - Bansal, Manish
N1 - Publisher Copyright:
© 2019 HMP Communications. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background. Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper-extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. Methods. A retrospective chart review of all patients who underwent cardiac catheterization via upper-extremity vascular access was performed. Results. Eighty-two cardiac catheterizations were attempted via upper-extremity vein on 72 patients. Successful access was obtained in 75 catheterizations (91%) in 67 patients. Median age at catheterization was 18.79 years (interquartile range [IQR], 13.02-32.75 years; n = 75) with a median weight of 59.4 kg (IQR, 43.3-76.5 kg; n = 75). The youngest patient was 4.1 months old, weighing 4.3 kg. Local anesthesia or light sedation was utilized in 46 procedures (61%). Diagnostic right heart catheterization was the most common procedure (n = 65; 87%), with intervention performed via the upper extremity in 8 cases (11%). Median fluoroscopy time was 10.02 min (IQR, 2.87-36.26 min; n = 75), with dose area product/kg of 3.765 μGy m2/kg (IQR, 0.74-34.12 μGy m2/kg; n = 64). Median sheath duration time was 48 min (IQR, 19.5-147 min; n = 57) and median total procedure time was 116 min (IQR, 80.5-299 min; n = 65). Median length of stay for outpatient procedures was 5.37 hr (IQR, 4.25-6.92 hr; n = 27). There were no procedural complications. Conclusion. Upper-extremity venous access is a useful, feasible, and safe modality for cardiac catheterization in the pediatric cardiac catheterization laboratory.
AB - Background. Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper-extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. Methods. A retrospective chart review of all patients who underwent cardiac catheterization via upper-extremity vascular access was performed. Results. Eighty-two cardiac catheterizations were attempted via upper-extremity vein on 72 patients. Successful access was obtained in 75 catheterizations (91%) in 67 patients. Median age at catheterization was 18.79 years (interquartile range [IQR], 13.02-32.75 years; n = 75) with a median weight of 59.4 kg (IQR, 43.3-76.5 kg; n = 75). The youngest patient was 4.1 months old, weighing 4.3 kg. Local anesthesia or light sedation was utilized in 46 procedures (61%). Diagnostic right heart catheterization was the most common procedure (n = 65; 87%), with intervention performed via the upper extremity in 8 cases (11%). Median fluoroscopy time was 10.02 min (IQR, 2.87-36.26 min; n = 75), with dose area product/kg of 3.765 μGy m2/kg (IQR, 0.74-34.12 μGy m2/kg; n = 64). Median sheath duration time was 48 min (IQR, 19.5-147 min; n = 57) and median total procedure time was 116 min (IQR, 80.5-299 min; n = 65). Median length of stay for outpatient procedures was 5.37 hr (IQR, 4.25-6.92 hr; n = 27). There were no procedural complications. Conclusion. Upper-extremity venous access is a useful, feasible, and safe modality for cardiac catheterization in the pediatric cardiac catheterization laboratory.
KW - Pediatric cardiology
KW - Venous access
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M3 - Article
C2 - 30765619
AN - SCOPUS:85065492884
SN - 1042-3931
VL - 31
SP - 141
EP - 145
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 5
ER -