Routine Postprocedure Chest Radiography Is Not Warranted After Right-Heart Catheterization

Area of Science:

• Cardiology
• Radiology
• Quality Improvement

Background:

• Right heart catheterization (RHC) is an invasive procedure.
• Endomyocardial biopsy (EMB) may be performed concurrently with RHC.
• Post-procedure complications, such as pneumothorax, are a concern.

Purpose of the Study:

• To evaluate the necessity of routine postprocedure chest radiography.
• To determine the incidence of pneumothorax after RHC with or without EMB.
• To assess the clinical significance of any detected pneumothoraces.

Main Methods:

• Retrospective quality improvement cohort study.
• Analysis of 6,036 outpatient RHC procedures (with or without EMB) from 2010-2017.
• Review of chest radiography reports to determine pneumothorax prevalence and characteristics.

Main Results:

• Pneumothorax prevalence was very low (0.07% corrected rate).
• Identified pneumothoraces were small (<1 cm) and clinically insignificant.
• A significant rate of false-positive findings on initial chest radiography was observed.

Conclusions:

• Routine postprocedure chest radiography after RHC is not indicated.
• The low incidence and clinical insignificance of pneumothorax do not warrant routine imaging.
• The study institution discontinued routine postprocedure chest radiography.