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.
Yang
Cheng-Hsu
CH
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan.
Guo
G Bih-Fang
GB
Yip
Hon-Kan
HK
Hsieh
Kelvin
K
Fang
Chi-Yung
CY
Chen
Shyh-Ming
SM
Cheng
Cheng-I
CI
Hang
Chi-Ling
CL
Chen
Mien-Cheng
MC
Wu
Chiung-Jen
CJ
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