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Transhepatic central venous access for cardiac catheterization and radiologic intervention
J L Johnson1, K E Fellows, J D Murphy
1Department of Radiology, Children's Hospital of Philadelphia, PA 19104, USA.
Catheterization and Cardiovascular Diagnosis
|June 1, 1995
Summary
Direct hepatic vein catheterization offers a safe and effective alternative for pediatric cardiac catheterization and radiologic interventions when standard venous access is unavailable. This technique provides a low-risk solution for complex cases, ensuring successful outcomes.
Area of Science:
- Pediatric Interventional Cardiology
- Vascular Access Techniques
- Radiologic Interventions
Background:
- Conventional venous access routes are often unavailable in pediatric patients requiring cardiac catheterization or radiologic interventions.
- Limited access options pose significant challenges for diagnosis and treatment in these young patients.
Purpose of the Study:
- To describe a novel technique for direct puncture and catheterization of hepatic veins in pediatric patients.
- To evaluate the efficacy and safety of this approach for cardiac catheterization and radiologic interventions.
Main Methods:
- Direct percutaneous puncture and catheterization of hepatic veins were performed in four pediatric patients.
- Procedures included cardiac catheterization and balloon dilatation of hepatic vein stenoses.
- Gelfoam embolization was utilized for hemostasis in the sheath tract.
Main Results:
- All eight direct hepatic vein punctures were successful.
- Three patients underwent successful cardiac catheterization, and one liver transplant patient had successful hepatic vein dilatation.
- Five hepatic vein dilatations and three right heart access procedures were completed without complications.
Conclusions:
- Direct percutaneous catheterization of hepatic veins is a feasible, effective, and low-risk alternative when conventional venous access is precluded in children.
- This technique expands interventional options for pediatric patients with complex vascular access needs.