Bilateral cardiac catheterizations: the safety and feasibility of a superficial forearm venous and transradial arterial approach.
The transradial approach for left heart catheterization has become increasingly popular recently because of its clinical benefits. We examined the safety and feasibility of a transforearm approach for bilateral cardiac catheterizations, using the radial artery and a superficial forearm vein (the cephalic, basilic, or median antecubital vein). Between August 2002 and October 2003, 296 right heart catheterizations were performed in our hospital. A superficial forearm vein was used in one group of 101 patients, of which 98 had a concomitant left heart catheterization through the radial artery. The femoral vein was used for right heart catheterization in the second group of 195 patients. Of these patients, 37 underwent left heart catheterization through the radial artery and 157 through the femoral artery. All instances of bilateral catheterizations were successful except for one complication of pseudoaneurysm occurring in the transfemoral group. The procedure time for right heart catheterization was significantly less in the forearm group than the femoral group. The transforearm group had a larger proportion of males and of patients undergoing diagnostic right heart catheterization for congestive heart failure, dilated cardiomyopathy, and ischemic cardiomyopathy. Patients with aortic stenosis (AS), atrial septal defect (ASD), and mitral stenosis (MS) were mainly restricted to the transfemoral approach. We conclude that the transradial artery and superficial forearm venous approach for bilateral cardiac catheterizations is a safe and feasible alternative to the femoral approach in a wide range of patients, with the exception of patients with AS, ASD, or MS.
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan.
Cheng-Hsu
CH
Yang
G Bih-Fang
GB
Guo
Hon-Kan
HK
Yip
Kelvin
K
Hsieh
Chi-Yung
CY
Fang
Shyh-Ming
SM
Chen
Cheng-I
CI
Cheng
Chi-Ling
CL
Hang
Mien-Cheng
MC
Chen
Chiung-Jen
CJ
Wu
D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D014680:Veins