Document Detail

The successful use of alternative routes of vascular access for performing pediatric interventional cardiac catheterization.
MedLine Citation:
PMID:  18727116     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of this study is to examine the safety/efficacy of alternative routes of vascular access (ARVA) for successful performance of interventions. BACKGROUND: Complex interventional catheterizations may be required in children with limited vascular access, vascular constraints relative to size, and hemodynamic instability. Our approach has been to utilize ARVA in selected cases. METHODS: ARVA pertains to any vessel excluding femoral, jugular/subclavian veins, or umbilical access. A retrospective review performed on patients with an intervention utilizing ARVA between August 1995 and January 2004 was performed. Patients were divided by clinical status: critically ill/emergent (A), elective cases (B). Procedural success was based on previously published criteria. RESULTS: Sixty-four interventions were performed in 50 patients using 54 ARVA. ARVA utilized: radial (1), axillary (2), brachial (2), carotid arteries (25); brachial (2) hepatic (9) veins; and open chest/direct cardiac puncture (13). ARVA provided successful access to target lesions. Interventions included stents (30), valvuloplasty (16), angioplasty (14), and one each of vascular occlusion, septal occlusion, accessory pathway ablation, and septostomy. Group A patients were smaller (P < 0.0002) and younger (P < 0.004) than B. All open chest/direct cardiac and the majority (71%) of carotid arterial approaches were performed in group A. Fifty-six (88%) inteventions were successful with no difference between groups A (88%) and B (86%). There were two complications. Neither resulted in long-term sequelae. CONCLUSIONS: ARVA may provide a strategic advantage that may be safely applied to a variety of interventions regardless of patient size or degree of illness. These techniques may further extend the scope of successful interventions in children.
Jennifer J Davenport; Lourdes Lam; Ruby Whalen-Glass; David G Nykanen; Redmond P Burke; Robert Hannan; Evan M Zahn
Related Documents :
15101866 - Pulmonary artery thermodilution cardiac output vs. transpulmonary thermodilution cardia...
8550396 - The history of angiography.
10579256 - Continuous cardiac output by femoral arterial thermodilution calibrated pulse contour a...
939116 - Axillary arterial monitoring.
889366 - Ascending aorta to bilateral femoral artery graft via a ventral subcutaneous route.
22757496 - Validation of a pressure diameter method for determining modulus and strain of collagen...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  72     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-01     Completed Date:  2008-11-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  392-8     Citation Subset:  IM    
Copyright Information:
Copyright 2008 Wiley-Liss, Inc.
Division of Cardiology and Cardiovascular Surgery, The Congenital Heart Institute at Miami Children's Hospital and Arnold Palmer Children's Hospital, Miami, Florida 33155, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary* / instrumentation
Cardiac Surgical Procedures* / instrumentation
Catheter Ablation*
Child, Preschool
Coronary Angiography
Critical Illness
Heart Catheterization* / adverse effects,  methods
Heart Defects, Congenital / radiography,  surgery,  therapy*
Infant, Newborn
Retrospective Studies
Surgical Procedures, Elective
Treatment Outcome
Comment In:
Catheter Cardiovasc Interv. 2008 Sep 1;72(3):399   [PMID:  18729171 ]

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

Previous Document:  Initial results of primary device closure of large muscular ventricular septal defects in early infa...
Next Document:  A unique complication of the retrograde approach in angioplasty for chronic total occlusion of the c...