Right Heart Catheterization-Related Complications: A Review of the Literature and Best Practices

Right heart catheterization (RHC) is considered to be the gold standard for the measurement of pulmonary artery pressure and has a class 1 indication to confirm the diagnosis of pulmonary arterial hypertension and to guide treatment decisions. Associated complications with RHC in contemporary practice are uncommon. In this review, we aim to summarize the complications that have been published in case reports or case series with updated management and techniques to prevent and mitigate complications. We searched the PubMed database for the following reports: “right heart catheterization,” “Swan-Ganz catheter,” “pulmonary artery catheter,” “balloon-tip catheter,” and “complication” or “adverse event.” Complications reported in 46 manuscripts were included in the final analysis. After evaluation of all reports, complications were grouped categorically. We found that the most commonly reported access site-related issues were either carotid artery injury or arteriovenous fistula formation, and injury to the tricuspid valve was the most commonly reported catheter-related complication. Our findings suggest that infrequent complications can occur with RHC and can be fatal. The optimal technique should be used to minimize complications. Operators should always be cautious during the procedure and monitor the patient closely.
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research

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CONCLUSIONS: PH-NF1 is characterized by a female predominance, a low DLCO and severe functional and hemodynamic impairment. Despite a potential benefit of PAH treatment, prognosis remains poor, and double-lung transplantation is an option for eligible patients. PMID: 32437637 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
Abstract Methods: The study design was cross-sectional. The subjects were adult uncorrected secundum ASD with PAH. Pulmonary artery pressure was measured with right heart catheterization. Pulmonary venous blood was obtained during catheterization for measuring endothelin-1, prostacyclin, and nitric oxide. Correlation tests were performed to determine any association between biomarkers and mean pulmonary artery pressure (mPAP). The levels of biomarkers were compared based on the severity of PAH. Statistical significance was determined at p
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
ConclusionsA clear trend towards worse outcome with larger TRV or TR% was shown; however, the number of events was insufficient for significant outcome differences. Prognostic value of quantitative TR should be investigated in a larger multicentre cohort. Effective RV ejection fraction may be considered an improved measure of RV function in PAH.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
An 11-year-old girl presented with pulmonary hypertension (PH), World Health Organization (WHO) functional class (FC) III associated with sickle cell disease (SCD) and history of a congenital diaphragmatic hernia (CDH) repair after birth. Her past medical history was significant for multiple episodes of pneumonia and pain crises. At age 7 years, her mean pulmonary artery pressure (mPAP) was 32 mmHg and pulmonary vascular resistance index (PVRi) was 3.6 Wood units x m2 by right heart cardiac catheterization (RHC) at another institute.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Conclusions: Impaired RV systolic function and LV global longitudinal strain, decrease of pulmonary artery distensibility, and CTD-PAH etiology, together with high NT-proBNP level, impair prognosis in pre-capillary PH patients. These findings are important for the risk stratification and management of pre-capillary pulmonary hypertension patients. PMID: 32283599 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
AbstractPulmonary artery aneurysm (PAA) is a common finding in patients with long-term pulmonary arterial hypertension (PAH). The influence of PAH severity in the development of PAA remains unclear. We sought to determine whether PAA development is related to PAH severity and whether treatment optimization based on risk profile estimation is effective to stop pulmonary artery (PA) enlargement. This is a retrospective study of 125 PAH patients who underwent an imaging test (computed tomography or magnetic resonance) combined with a right heart catheterization within a six-month period. A multivariate analysis was performed ...
Source: Heart and Vessels - Category: Cardiology Source Type: research
el NF Abstract BACKGROUND: In animal models of pulmonary arterial hypertension (PAH), angiotensin converting enzyme type 2 (ACE2) and Angiotensin 1-7 [Ang-(1-7)] have been shown to have vasodilatory, anti-proliferative, anti-fibrotic and anti-hypertrophic properties. However, the status and role of the ACE2-Ang-(1-7) axis in human PAH is incompletely understood. METHODS: We studied 85 patients with a diagnosis of PAH of distinct etiologies. Fifty-five healthy blood donors paired for age and sex served as controls. Blood samples were obtained from the pulmonary artery in patients with PAH during right heart ca...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Eur Respir J Source Type: research
Objectives: We investigated whether concentrations of circulating microRNAs differ across the hypertensive right ventricle and pulmonary circulation, and correlate with hemodynamic/echocardiographic variables in patients with pulmonary arterial hypertension versus nonpulmonary arterial hypertension controls. Design: Prospective blood collection during cardiac catheterization from the superior vena cava, pulmonary artery, and ascending aorta in 12 children with pulmonary arterial hypertension and nine matched nonpulmonary arterial hypertension controls, followed by an unbiased quantitative polymerase chain reaction arr...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Feature Cardiac Intensive Care Source Type: research
Exercise during right heart catheterization (RHC) can demonstrate cardiopulmonary hemodynamic abnormalities not evident at rest. The relationships of pulmonary artery pressure (PAP) or pulmonary artery wedge pressure (PAWP) to cardiac output (CO) do not fully consider that PAP and PAWP should also be closely related. Therefore, we sought to expand our understanding of cardiopulmonary hemodynamic abnormalities by calculating the ratio of PA pulse pressure to PAWP during exercise in health and in patients with dyspnea and uncertain mechanisms of pulmonary hypertension (PH).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (15) Source Type: research
A20 attenuates hypoxia-induced pulmonary arterial hypertension by inhibiting NF-κB activation and pulmonary artery smooth muscle cell proliferation. Exp Cell Res. 2020 Mar 28;:111982 Authors: Chen M, Ding Z, Zhang F, Shen H, Zhu L, Yang H, Chen S Abstract PAH is a progressive disease characterized by uncontrolled proliferation of PASMCs. Zinc finger protein A20 is a negative feedback regulatory protein of NF-κB activity. The aim of this study was to evaluate zinc finger protein A20 can alleviate PAH in hypoxia exposed mice. C57BL/6 mice received a tail vein injection of adenovirus-mediated...
Source: Experimental Cell Research - Category: Cytology Authors: Tags: Exp Cell Res Source Type: research
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