Turk Kardiyol Dern Ars. Ahead of Print: TKDA-70558 | DOI: 10.5543/tkda.2019.70558
Right-heart catheterization using antecubital venous access in patients with complex congenital heart defects and Glenn anastomosis
Sezen Atik Ugan
, Selman Gökalp, Betül Çınar, Irfan Levent Saltık
Department of Pediatric Cardiology, İstanbul University, Cerrahpaşa Medical Faculty, İstanbul, Turkey
OBJECTIVES The technique and features of the antecubital venous approach in pediatric patients with complex congenital heart defects and a Glenn anastomosis were presented in this article.
BACKGROUND In the current era, right-heart catheterization using the antecubital veins has regained attention, and studies demonstrating the feasibility and safety of antecubital access have been published in adults. However, no changes have been observed in the preferred entrance sites in right-heart catheterizations in children with congenital heart diseases.
METHODS Between January 2014 and August 2017, we performed right cardiac catheterizations through the antecubital fosse veins in 18 patients with various clinical indications.
RESULTS Ten patients (55%) were male and eight patients were female. All patients except one had a complex congenital heart disease with a Glenn anastomosis. One patient had been operated on for a sinus venosus atrial septal defect and an abnormal pulmonary venous return and had a total occlusion of the superior vena cava. A diagnostic catheterization was done in all of the patients. Additional procedures consisted of a balloon test occlusion of the pulmonary valve in two patients, a superior vena cava-right pulmonary artery anastomosis dilatation in one, and an abnormal veno-venous collateral occlusion with various devices in two patients
CONCLUSIONS The antecubital venous approach can be performed easily and safely for diagnostic and therapeutic catheterization in patients with complex congenital heart defects. We advocate that the antecubital venous approach should be the first site selected for right-heart catheterization, especially in patients with a Glenn anastomosis.
right heart catheterization, antecubital venous access, complex congenital heart defects, Glenn anastomosis, children, diagnostic catheterization
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Corresponding Author: Sezen Atik Ugan, Türkiye