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Modified Judkins catheters for selective coronary angiography in infants and young children
1Division of Cardiology, Children's Hospital of Orange County, Orange County, California 92688, USA.
Insights
Modified 4 Fr Judkins catheters with shorter tips effectively enable selective coronary angiography in infants and children. These specialized catheters offer efficient cannulation and reduced fluoroscopy times for pediatric cardiac procedures.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Device Engineering
Background:
- Selective coronary angiography is crucial for diagnosing pediatric heart conditions.
- Traditional Judkins catheters may present challenges in pediatric anatomy.
- Modified catheter tips are being explored to improve procedural success in young patients.
Purpose of the Study:
- To evaluate the efficacy and safety of 4 Fr Judkins catheters with modified shorter tips.
- To assess the suitability of these catheters for selective coronary angiography in infants and young children.
- To determine optimal catheter selection based on patient size.
Main Methods:
- Retrospective analysis of 20 pediatric patients (6 weeks to 3.8 years).
- Performance assessment of modified 4 Fr Judkins catheters (JR and JL) with 1.5-cm and 2.5-cm curves.
- Evaluation of cannulation success rates, procedure times, and fluoroscopy times.
Main Results:
- Successful cannulation of 36 out of 37 coronary arteries.
- Median procedure times: 95 seconds (right), 50 seconds (left).
- Median fluoroscopy times: 1.1 minutes (right), 0.7 minutes (left).
- JL 1.5 cm suitable for patients <75 cm; JR 1.5 cm for patients up to 85 cm; 2.5 cm curves for taller patients.
Conclusions:
- Modified 4 Fr Judkins catheters are effective for pediatric selective coronary angiography.
- Catheter curve selection should be tailored to patient height for optimal outcomes.
- These devices represent a valuable advancement in pediatric cardiac interventional tools.
Abstract:
The purpose of this study was to assess 4 Fr Judkins catheters with modified shorter tips for performing selective coronary angiography in infants and young children. Twenty patients ranging 6 weeks to 3. 8 years of age were enrolled. Retrograde left heart catheterization and selective coronary angiography were performed. Right (JR) and left (JL) catheters with modified 1.5- and 2.5-cm curves (Cordis) were used. Thirty-six of 37 coronary arteries were successfully cannulated and demonstrated. Median procedure time was 95 sec for the right and 50 sec for the left coronary artery. Median fluoroscopy time was 1.1 min for the right and 0.7 min for the left coronary artery. The JL 1.5 appeared best suited for patients less than 75 cm tall. The JR 1.5 was suitable for patients up to 85 cm tall. Taller patients required the 2.5-cm curves. It is concluded that these modified 4 Fr Judkins catheters were effective.