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Transthoracic access for cardiac catheterization.

Kevin O Maher1, Kenneth A Murdison, William I Norwood

  • 1Nemours Cardiac Center, A.I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware 19899, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 3, 2004
PubMed
Summary

Transthoracic catheterization provides reliable pulmonary venous atrium access for Fontan patients. This approach enables complex therapeutic procedures, avoiding repeat open-heart surgery.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Patients with congenital heart disease (CHD) undergoing Fontan palliation often have restricted access to the pulmonary venous atrium.
  • Limited access poses challenges for diagnostic and therapeutic cardiac catheterization in this population.

Observation:

  • A novel transthoracic approach to the pulmonary venous atrium was developed and applied to 22 patients (14 months to 25 years).
  • The procedure involved fluoroscopic and angiographic guidance for needle insertion, wire placement, and sheath insertion into the pulmonary venous atrium.

Findings:

  • Successful transthoracic access to the pulmonary venous atrium was achieved in all 22 patients.
  • Complex therapeutic cardiac catheterization procedures were completed successfully in all patients via this approach.

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Implications:

  • Transthoracic access to the pulmonary venous atrium is a reliable and rapid method for Fontan patients.
  • This technique facilitates advanced therapeutic interventions in the catheterization lab, potentially eliminating the need for further open-heart surgeries.