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PubMed · 639534

Long-term radial artery cannulation: effects on subsequent vessel function.

R F Bedford
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Abstract

Radial artery function was studied in 114 consecutive patients by arteriography, Doppler ultrasound flow detection, and physical examination following prolonged (1-10 days) percutaneous cannulation with a single type of 20-gauge catheter. Cannulations lasting 1-3 days produced 11% arterial occlusion, whereas those lasting 4-10 days induced 29% incidence of occlusion (p less than 0.05). In addition, a significantly higher incidence of cannula dysfunction (38% versus 18%, p less than 0.05) and thrombus formation (0-3+ scale) was also observed in the group cannulated 4-10 days as compared with the group of shorter duration. The risk of vascular complications arising from percutaneous radial artery cannulation with 20-gauge catheters increases markedly after 3 days.

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Arterial Occlusive DiseasesArteriesCatheterizationHumansRadiusTime FactorsJournal ArticleResearch Support, U.S. Gov't, P.H.S.

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R F Bedford. Long-term radial artery cannulation: effects on subsequent vessel function.. https://doi.org/10.1097/00003246-197801000-00016

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Pulmonary arterial reconstruction for pulmonary coarctation in early infancy.

BACKGROUND: Pulmonary atresia with pulmonary coarctation may complicate diminished and unbalanced pulmonary development. The aim of this study is to assess the outcome of pulmonary arterial reconstruction with cardiopulmonary bypass in early infancy for sufficient and balanced pulmonary development. METHODS: We performed a retrospective review of 15 patients with pulmonary coarctation younger than 4 months of age who underwent pulmonary arterial reconstruction between 2001 and 2005. The mean age and weight were 42.2 days and 3.62 kg, respectively. The patient population included 5 biventricular repair candidates and 10 Fontan candidates. To evaluate the pulmonary arterial development, the preoperative and postoperative pulmonary arterial index and minimum diameter of the pulmonary artery were compared. RESULTS: No early or in-hospital deaths occurred, and there was no nonconfluent pulmonary artery development or segmental mal-development after a mean follow-up period of 14.9 months. Immediate pulmonary flow regulation was required in 2 patients because of excessive pulmonary flow. The mean pulmonary arterial index increased significantly from 103 mm2/m2 to 343 mm2/m2, and the mean minimum diameter of the pulmonary artery increased significantly from 2.02 mm to 4.45 mm. Four biventricular repair candidates completed definitive repair, and 2 required surgical reintervention in the pulmonary artery. Six Fontan candidates completed the Glenn procedure, and 1 completed the Fontan procedure. Three required surgical reintervention in the pulmonary artery. Two late deaths occurred after the Glenn procedure because of ventricular dysfunction and respiratory infection. CONCLUSIONS: Pulmonary arterial reconstruction in early infancy provides sufficient and balanced pulmonary arterial development for pulmonary atresia with pulmonary coarctation.

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