title: Femoral venous hemostasis in children using the technique of "figure-of-eight" sutures.
abstract: BACKGROUND
  Structural heart interventions require the use of relatively large-diameter delivery sheaths or latex nylon net balloon catheters, which results in a relatively large-diameter venous puncture point. At present, femoral venous hemostasis is achieved by manual compression. A temporary figure-of-eight subcutaneous suture has been introduced to achieve immediate postprocedural femoral venous hemostasis after using a ≥24Fr sheath in an adult. This method is not well evaluated in children.
  
  
  METHODS
  We report our experience using this technique in children treated with 7-14Fr sheaths. From May 2009 to March 2012, 104 children (ages ranging from 3 to 10 years, mean 8.1 ± 1.6 years) with atrial septal defects (n = 86) and pulmonary valve stenosis (n = 18) underwent percutaneous transcatheter interventions. Sheath sizes used were ≥7Fr (7Fr, n = 5; 8Fr, n = 29; 9Fr, n = 14; 10Fr, n = 15; 12Fr, n = 19; 14Fr, n = 22).
  
  
  RESULTS
  A total of 102 patients had immediate femoral vein hemostasis, and 2 developed a femoral vein hematoma requiring manual compression. One patient was diagnosed with a femoral artery pseudoaneurysm during hospitalization. On follow-up, there was no evidence of hematoma or thrombosis.
  
  
  CONCLUSIONS
  The "figure-of-eight" suture technique is effective and safe, achieving immediate hemostasis after the use of large femoral vein sheaths in children.
authors.affiliation: Department of Cardiology, No.411 Hospital of PLA, Shanghai, China; Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Zhifu
authors.initials: Z
authors.lastname: Guo
authors.forename: Yuan
authors.initials: Y
authors.lastname: Bai
authors.forename: Xianxian
authors.initials: X
authors.lastname: Zhao
authors.forename: Yongwen
authors.initials: Y
authors.lastname: Qin
authors.forename: Shaoping
authors.initials: S
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Xinmiao
authors.initials: X
authors.lastname: Huang
authors.forename: Songhua
authors.initials: S
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
mesh_terms: D017541:Aneurysm, False / Q000209:etiology; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D062906:Cardiac Catheters; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005268:Femoral Vein; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000628:therapy*; D006406:Hematoma; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000009:adverse effects; D006801:Humans; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D011677:Punctures; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology
keywords: Femoral Vein; Hemostasis; Structural Heart Disease