Heart catheterization

Left heart catheterization via the femoral artery has risk of major and minor complications, such as bleeding hematoma formation, retroperitoneal bleeding, pseudoaneurysm formation and arteriovenous fistula formation.

Left heart catheterization via femoral artery associated with 1.6-19% complication rate associated with hemostasis.

Access site hemostasis can be achieved by manual compression, arterial closure devices and mechanical compression devices.

Arterial closure devices have reduced duration of patient’s bed rest after the procedure.

Ambulation after diagnostic cardiac catheterization using a transfemoral approach typically requires 2-4 hours of bed rest after the sheath removal and acquisition of hemostasis by manual compression.

Minor vascular complications at the femoral artery site occur in 5-15% and major complications in 0.1%-2% of cases.

In a study of 1009 outpatients at the Mayo clinic (Doyle et al) evaluated with diagnostic cardiac catheterizations using a 5F vascular access transfemoral approach ambulation 1 hour after sheath removal with standard manual compression to achieve hemostasis was associated with minor vascular complication rate of 3.3% and a major complication rate of 0.1%.

In the above study of 1009 procedures the minor complications consisted of small, <4cm, hematomas at the access site in 1.4% of cases, or rebleeding in 1.9% of cases.

In the above study most patients did not have anticoagulation and the data may not be applicable to patients on high dose anticoagulants, or who required larger sheath sizes, who have peripheral arterial disease or uncontrolled hypertension.

Right heart catheterrization involves placing a catheter in the venous system of the heart and measuring pressures and oxygen saturations in the superior vena cava, inferior vena cava, right atrium, right ventricle, and pulmonary artery, and in the wedge position.


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