Percutaneous Right and Left Heart Catheterization in Children

Experience with 1,000 Patients

Simovitch, Harvey M.D.
Hohn, Arno R. M.D.
Wagner, Henry R. M.D.
Vlad, Peter M.D.
Subramanian, S. M.B.
Lambert, Edward C. M.D.

From the Children's Hospital and the Department of Pediatrics, State University of New York at Buffalo, School of Medicine, Buffalo, New York, and the Medical College of South Carolina Hospital, Charleston, South Carolina.

Received September 29, 1969; revision accepted for publication October 30, 1969.

Circulation 41(3):p 513-517, March 1970.

One thousand patients, ranging in age from 4 months to 26 years, underwent percutaneous catheterization of the femoral artery and femoral vein. Cardiac catheterization was combined with selective angiocardiography in all patients.

The catheter entered the right ventricle in 972 of 990 patients (98%) and the left ventricle in 832 of 856 (97%), including 82 of 89 patients (92%) with aortic stenosis.

There were no deaths, perforations of the heart, or loss of tissue. The peripheral pulse was decreased in 6% (49 of 856) and absent in 2% (17 of 856). Other complications included two uneventful perforations of the aortic arch, two lacerations of the femoral artery, three lacerations of the femoral vein, a false aneurysm of the femoral artery, and a cerebrovascular accident.

Our findings indicate that, in children more than 2 years old and weighing more than 10 kg, the percutaneous method is safe, informative, and associated with less arterial circulatory complications than the approach from the surgically exposed artery.