Feasibility of in vivo pressure measurement using a pressure-tip catheter via transventricular puncture

Pressure-tip catheters (PTCs) are used to evaluate ventricular mechanics during surgical repair of congenital heart disease in children. Studies in infants require miniaturized sensors. We compared the safety and accuracy of a 2-Fr ultraminiature PTC with a 5-Fr PTC. In 10 piglets (weight 19-22 kg), a 5-Fr PTC was inserted through a 3-mm apical puncture with a #11 blade. A 20-gauge angiocatheter was inserted using a separate site. A 2-Fr PTC was threaded through the angiocatheter lumen. The angiocatheter was withdrawn, leaving the 2-Fr PTC within the left ventricle (LV). Left ventricular pressure (LVP) changes were measured during three inferior vena caval occlusions. Reliability coefficients demonstrated correlation between the 2-Fr PTC and 5-Fr PTC for LV end-diastolic pressure (0.90-0.95), peak LVP (0.92-0.99), and the maximal (0.87-0.93) and minimal (0.89-0.94) first derivatives of LVP. Bland-Altman analysis demonstrated agreement for all variables. Blood loss was trivial with pressure manipulation and catheter placement and removal. Pressure measurements using the 2-Fr PTC were accurate and comparable with those from the 5-Fr PTC. Transventricular placement of a 2-Fr PTC is feasible and should allow evaluation of ventricular mechanics during surgical repair of congenital heart disease.