Retrograde Arterial Catheterization of the Left Heart

Vlad, Peter; Hohn, Arno R.; Lambert, Edward C.

doi:10.1161/01.cir.29.5.787

Cited by 62 publications

(18 citation statements)

References 13 publications

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“…In some cases studied, no decrease in limb blood flow was found to account for a shortened limb after catheterization [5,23] . In addition, while in some cases with vascular impairment surgical correction achieved compensatory growth of the limb, in others it did not [7,22,231 .…”

Section: Discussionmentioning

confidence: 99%

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Immediate complications and late sequelae of arterial catheterization in children with congenital heart disease

1983

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Early vascular complications and late sequelae are reported in relation to 195 left heart catheterizations, 125 performed by brachial arteriotomy (BA), and 70 by percutaneous femoral artery puncture (FAP) with the Seldinger technique. Vascular complications occurred in 25 patients, 11 requiring surgical intervention, which was successful in restoring normal circulation in all. The rate of complications was higher after FAP in children 6 years old or less, while after BA the rate was significantly higher in patients of 2 years or older. In patients under 2 years, brachial artery suture repair resulted in more complications than ligation, but the cases were not randomized. Late follow-up of 101 catheterizations (35 FAP, and 66 BA, of which 38 were ligated and 28 sutured) included clinical evaluation, Doppler pressure measurements, and a comparison of the length and bone development of the catheterized and non-catheterized limbs. All these have indicated an absence of any serious late sequelae in this group 6 months to 9 years (average 4 years) after catheterization.

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Section: Discussionmentioning

confidence: 99%

“…Although there are many reports of iatrogenic injuries following left heart catheterization in children [4,16,22,23,24], the incidence of these mishaps is only reported by a few [14,21] . In these reports the incidence of complications was similar to that in the present report .…”

Section: Discussionmentioning

confidence: 99%

Immediate complications and late sequelae of arterial catheterization in children with congenital heart disease

1983

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“…These include thrombosis or stenosis of the vessel, compartment syndrome and the extravasation of infused fluids which may lead to skin breakdown, infection, and scarring. Ischaemia of the limb, with reduced pulses and temperature, occurs in 2% to 33% of children after arterial cannulation [1][2][3] and impaired growth has been recognised for 30 years. 4,5 Rosenthal et al 6 considered that discrepancy of limb length was a rare complication and Hawker et al 7 stated that clinical assessment of leg length and calf size agreed to "within 5%" after cannulation.…”

Section: Discussionmentioning

confidence: 99%

Arrest of the growth plate after arterial cannulation in infancy

Macnicol

Anagnostopoulos

2000

The Journal of Bone and Joint Surgery. British volume

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Seven children who had partial arrest of the growth plate after neonatal arterial cannulation, developed obvious skeletal changes in adolescence. Cannulation of the femoral artery produced ischaemia which led to four cases of ipsilateral shortening of the lower limb and one of partial arrest of the proximal femoral physis with subsequent coxa valga. The two arrests in the upper limb affected the humerus, ulna and radius, and the radius alone, after cannulation of the brachial and radial arteries, respectively. These late effects of cannulation are not widely appreciated, and may occur as a result of thrombosis rather than extravasation. Arrest of the growth plate (physis) may complicate arterial cannulation during infancy and childhood. The resultant discrepancy or deformity of the limb is not always recognised before skeletal maturity, by which time a relatively simple correction by epiphysiodesis is impossible. We describe seven cases of physeal injury after arterial cannulation in which complications such as perforation of the vessel wall, aneurysm or extravasation were not sustained. Two cases involved the upper limb, producing shortening of the radius principally, but also of the ulna and the humerus. Four cases of femoral and tibial shortening occurred as a result of femoral cannulation. Although there has been debate in the literature about the cause of the resultant leg-length disparity, since an intrinsic mild discrepancy cannot always be ruled out in each of our patients, the ipsilateral leg had developed mild circulatory impairment after the cannulation. The last case involved the lateral portion of the proximal femoral growth plate.

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“…In some cases, however, left sided procedures and retrograde aortography are required for the diagnosis of certain congenital heart diseases, such as large ventricular septal defect, patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch and their various combinations (Vlad et al 1964 ;Simonovitch et al 1970). Retrograde arterial catheterization and aortography in these infants are accomplished by percutaneous approach or arteriotomy (Sanger et al 1974).…”

Section: Discussionmentioning

confidence: 99%