Right heart catheterization using antecubital venous access: Feasibility, safety and adoption rate in a tertiary center. Issue 1 (9th November 2013)

• Record Type: Journal Article
• Authors: Shah, Sachin; Boyd, Graham; Pyne, Christopher T.; Bilazarian, Seth D.; Piemonte, Thomas C.; Jeon, Cathy; Waxman, Sergio
• Is Part Of: Catheterization and cardiovascular interventions. Volume 84:Issue 1(2014:Jul. 01)
• Page Start: 70
• Page End: 74
• Publication Date: 2013-11-09
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25249
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25249-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine feasibility, safety, and adoption rates of right heart catheterization (RHC) using antecubital venous access (AVA) as compared to using the traditional approach of proximal venous access (PVA).</p> </sec> <sec id="ccd25249-sec-0002" sec-type="section"> <title>Background</title> <p>RHC via PVA (i.e., internal jugular, femoral or subclavian) is generally a low risk procedure; however, complications may occur and are usually access site related. RHC via an antecubital approach has regained attention given the increase in transradial left heart catheterizations.</p> </sec> <sec id="ccd25249-sec-0003" sec-type="section"> <title>Methods</title> <p>Patients undergoing RHC for any indication at a single large academic medical center were identified over a 5‐year period (January 2008 to December 2012) from a database. Medical records were retrospectively analyzed for demographic, procedural and outcomes data.</p> </sec> <sec id="ccd25249-sec-0004" sec-type="section"> <title>Results</title> <p>Two hundred seventy‐two RHC procedures were included (106 AVA, 166 PVA). The adoption rate of AVA for RHC increased rapidly since its introduction in our laboratory in 2010 (100% PVA in 2008 and 2009, 85% AVA in 2012). All procedures were successful; however, 6% of procedures required additional, alternate access to the original site. Initial success rates were similar in the two groups (91 vs. 96% for AVA and PVA respectively, <italic>P</italic> = 0.12). Fluoroscopy time was shorter in the group of patients who underwent the procedure via AVA. The complication rate was 0% in the AVA group compared with 3% in the PVA group (<italic>P</italic> = 0.16).</p> </sec> <sec id="ccd25249-sec-0005" sec-type="section"> <title>Conclusion</title> <p>RHC via the AVA is a feasible and safe alternative to PVA. Our experience and rapid adoption support the use AVA as the access site of choice for RHC in uncomplicated patients. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>