Percutaneous Heart Catheterization in Infants and Children

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Abstract
In this prospective study of 150 consecutive heart catheterizations, the percutaneous method of right and left heart catheterization was used in 127 patients. In infants and children weighing more than 10 pounds, the percutaneous method was found to be an effective technic associated with a 3% incidence of diminished arterial pulses in the catheterized limb. All patients in this weight group, except one, had left heart catheterization by this technic. The method was deemed time-saving compared to a cutdown, and complications related to the use of end-hole catheters and guide wires were minimal. With regard to venous catheterization, a previous femoral vein cutdown contra-indicated application of the percutaneous method to the same vein, while a previous saphenous vein cutdown did not interfere. A vessel catheterized percutaneously may be recatheterized without difficulty. Thrombi in the arterial catheter and small size of the patient were two factors which had significant correlation with the delay in return of distal pulses to normal. Palpation of distal pulses before and at intervals following the catheterization was found to be the most satisfactory way of detecting arterial complications.