title: Percutaneous trans-jugular technique for continuous perioperative monitoring of intra-cardiac and pulmonary artery pressures during cardiac surgery for congenital heart disease.
abstract: OBJECTIVE
  To observe the safety of trans-jugular pressure-monitoring catheter insertion at a tertiary care teaching hospital in Rawalpindi, Pakistan.
  
  
  METHODS
  The observational study was carried out at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from January 1, 2004 to March 31, 2010. All patients electively scheduled to undergo cardiac surgery for congenital heart disease who had percutaneous trans-jugular pressure monitoring catheters inserted peri-operatively were included in the study. Dedicated Medtronic 3 Fr pressure monitoring catheters were passed through internal jugular vein using the modified Seldinger. The patients were followed up during the hospital stay for complications related to catheter insertion/removal. Data was analysed using SPSS version 15.
  
  
  RESULTS
  Of the 572 patients in the study, the catheters were ultimately positioned with the tips in the pulmonary artery in 447 (78.14%)patients, right ventricle 54 (9.44%) patients, left atrium in 52 (9.09%), and in both pulmonary artery and left atrium in 19 (3.32%) patients. Duration of pressure monitoring from all the chambers was 53 +/- 19 hours post-operatively. Transient and self-limiting atrial or ventricular ectopic beats were noticed in 163 (27.58%) patients during insertion. Catheter was found to be non-functional in 12 (2.03%) patients. Only one (0.16%) patient experienced recurrent tachyarrhythmia which required the withdrawal of catheter.
  
  
  CONCLUSIONS
  Insertion of trans-jugular pressure monitoring catheters during cardiac surgery for congenital heart disease is a safe and reliable technique.
authors.affiliation: Department of Cardiac Anaesthesia & Intensive Care, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, The Mall, Rawalpindi, Pakistan. draqeel@gmail.com
authors.forename: Syed Aqeel
authors.initials: SA
authors.lastname: Hussain
authors.forename: Shahab
authors.initials: S
authors.lastname: Naqvi
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Ahmed
authors.forename: Umair
authors.initials: U
authors.lastname: Younis
authors.forename: Kamal
authors.initials: K
authors.lastname: Saleem
authors.forename: Syed Muzaffar
authors.initials: SM
authors.lastname: Hasan
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology*; D062185:Atrial Pressure; D006348:Cardiac Surgical Procedures / Q000379:methods; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D062905:Central Venous Catheters / Q000009:adverse effects; D002675:Child, Preschool; D019544:Equipment Failure Analysis; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010154:Pakistan; D011183:Postoperative Complications / Q000175:diagnosis*; D011651:Pulmonary Artery / Q000601:surgery; D011669:Pulmonary Wedge Pressure; D015203:Reproducibility of Results; D016896:Treatment Outcome