[Bedside cardiac catheterization. Advantages and disadvantages].

Area of Science:

• Cardiology
• Diagnostic Procedures
• Critical Care Medicine

Context:

• Bedside heart catheterization (BHC) was performed on 300 patients between 1973 and 1985.
• The study population primarily consisted of patients who had suffered a myocardial infarction (MI), with many in advanced Killip functional classes (II-IV).
• A subset of patients underwent BHC due to congestive heart failure.

Purpose:

• To evaluate the advantages and risks associated with bedside heart catheterization (BHC).
• To assess the diagnostic utility of wedge pressure (WP) measurements in patients with MI and heart failure.
• To identify factors associated with complications during BHC.

Summary:

• BHC was successful in 96% of cases, with wedge pressure (WP) measured in 78.7%.
• A significant proportion of patients, even in higher functional classes, had WP < 18 mmHg, indicating the procedure's value in complex MI cases.
• Minor complications occurred in 11% and major complications in 15%, including pulmonary infarction and phlebitis. Longer procedure maintenance time was linked to increased complications.

Impact:

• Highlights the utility of BHC in diagnosing and managing complicated myocardial infarction and heart failure.
• Identifies pulmonary infarction and phlebitis as key complications associated with prolonged BHC procedures.
• Provides insights into the hemodynamic profiles of MI patients, challenging traditional assumptions about wedge pressure thresholds.