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Transhepatic approach for cardiac catheterisation in children: initial experience
K A McLeod1, A B Houston, T Richens
1Department of Cardiology, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, UK.
Heart (British Cardiac Society)
|November 26, 1999
Summary
The transhepatic approach offers a safe alternative for pediatric cardiac catheterization when conventional venous access is blocked. This technique, using the Seldinger technique, is effective for children with venous occlusions.
Area of Science:
- Pediatric Cardiology
- Interventional Radiology
- Vascular Access
Background:
- Conventional venous access for cardiac catheterization in children can be challenging.
- Venous occlusion, particularly of the femoral vein and superior vena cava, necessitates alternative approaches.
Purpose of the Study:
- To evaluate the initial experience and feasibility of the transhepatic approach for pediatric cardiac catheterization.
- To assess the safety and efficacy of this technique when standard venous access is impossible.
Main Methods:
- Percutaneous transhepatic cardiac catheterization was performed in six instances on five pediatric patients (4-36 months).
- Ultrasound guidance was utilized in most cases to identify hepatic veins for sheath insertion via the Seldinger technique.
- Patients had documented femoral venous occlusion, and most also had superior vena cava occlusion.
Main Results:
- The transhepatic approach was successful in all six procedures.
- Procedure times averaged 138 minutes, with screening times averaging 16.8 minutes.
- A single serious complication (retroperitoneal bleed) occurred in one patient.
Conclusions:
- The percutaneous transhepatic technique is a safe and viable alternative for pediatric cardiac catheterization in cases of multiple venous occlusions.
- The procedure is straightforward, utilizing standard Seldinger technique and equipment.