Cardiac catheterization in the neonate. A comparison of three techniques

This study evaluated three methods of catheter entry for cardiac catheterization in neonates less than one week of age. Eighty-five neonates underwent venous catheterization through the umbilical vein, 77 by saphenous or femoral cutdown, and 31 by femoral percutaneous entry. Of these 194 neonates, 128 also had an aortic catheter introduced via the umbilical artery. Umbilical vein catheterizations took an average of 115 minutes, 30 minutes shorter than either of the other techniques. Fatal complications following catheterization occurred in 10 of the 194 neonates (5%) three of these were related to catheterization technique. Diagnostic cardiac catheterization and balloon atrial septostomy may be performed most quickly by way of the umbilical vessels. Percutaneous entry of the femoral vein in this series carried the lowest complication rate; cutdown entry resulted in the highest complication rate.