Document Detail


Femoral vascular access complications in adult congenital heart disease patients: audit from a single tertiary center.
MedLine Citation:
PMID:  18837812     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the rate of vascular access complications in patients with adult congenital heart disease (ACHD).
BACKGROUND: Complications of femoral access following coronary angiography or percutaneous coronary intervention have been studied extensively, but the complication rate following catheterization and intervention in ACHD patients is poorly documented. DESIGN, SETTING, AND OUTCOME MEASURES: We present a retrospective audit of vascular access complications in a large tertiary ACHD center over a 12-month period. Complications were defined as any clinically significant hematoma, pseudoaneurysm, arteriovenous fistula, or bleeding resulting in the need for imaging, transfusion, vascular or radiological intervention, or delayed discharge.
RESULTS: Of 197 procedures (102 interventions and 95 cardiac catheterizations), a complication rate of 3.6% was identified, comparable to that of coronary angiography and percutaneous coronary intervention. The main complications were femoral artery pseudoaneurysm and hematoma resulting in delayed discharge by a mean of 2(2/3) days (range 1-4 days). Predictors of risk for vascular complications include female sex, history of diabetes, and anticoagulation; larger sheath sizes and obesity were not associated with higher complication rate.
CONCLUSIONS: Adult congenital heart disease patients represent a unique and ever-growing population with a higher incidence of catheterization as children, surgical cut-down scars and anatomical variants. We present a low incidence of femoral access complications in interventional and diagnostic procedures in a large series of ACHD patients over a 12-month period. Patients with risk factors for vascular complications may be considered for device closure of the venous access site.
Authors:
Colin D Chue; Lucy E Hudsmith; Oliver Stumper; Joseph De Giovanni; Sara A Thorne; Paul Clift
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  3     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-10-07     Completed Date:  2008-12-18     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
Affiliation:
Department of Grown-Up Congenital Heart Disease, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK. colin.chue@nhs.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aneurysm, False / epidemiology,  etiology
Arteriovenous Fistula / epidemiology,  etiology
Coronary Angiography / adverse effects*,  statistics & numerical data
Female
Femoral Artery*
Heart Catheterization / adverse effects*,  statistics & numerical data
Heart Defects, Congenital / epidemiology,  radiography*
Hematoma / epidemiology,  etiology*
Hemorrhage / epidemiology,  etiology
Humans
Incidence
Male
Medical Audit
Middle Aged
Retrospective Studies
Risk Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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