Abstract 18206: Patient Factors but not the use of Novel Anticoagulants or Warfarin are associated With Internal Jugular Vein access site Hematoma After Right Heart Catheterization
Introduction: Right heart catheterization (RHC) is routinely performed to assess hemodynamics. Generally, anticoagulants are held prior to the procedure. At our center, anticoagulants are continued and ultrasound guidance is always used for internal jugular vein access. A micropuncture access kit is used to place a 5 or 6 French sheath using the Modified Seldinger technique. Manual compression is applied for 10-15 minutes and patient is observed for at least 2 hours after the procedure. In a retrospective analysis, we investigated the risk of bleeding complications associated with RHC via the internal jugular vein in patients with and without full anticoagulation.
Methods and Results: Our catheterization laboratory database was searched for adult patients who underwent RHC by a single operator between January 2012 and December 2015. A total of 571 patients were included in the analysis. Baseline characteristics, labs, relevant invasive hemodynamics, co-morbid conditions and incidence of access site hematoma are shown in the Table. Multivariable binary logistic regression was performed using IBM SPSS v23.0 software. A statistically significant association of BMI (p=0.02, 95% CI 1.0, 1.1), right atrial pressure (p=0.03, 95% CI 0.7, 0.9) and dialysis-dependence (p=0.007, 95% CI 0.1, 0.6) with access site hematoma was observed. There was no association of access site hematoma with the use of anticoagulants (p=0.998).
Conclusions: The incidence of internal jugular vein access site hematoma is small when using careful access technique for RHC even with continued use of novel oral anticoagulants and Warfarin. Patient characteristics and co-morbid conditions are related to bleeding complications.
Author Disclosures: O. Dasa: None. Q. Shafiq: None. M. Ruzieh: None. K. Shunnar: None. M. Al-Dabbas: None. L. Alhazmi: None. S. Khouri: None. G.V. Moukarbel: None.
- © 2016 by American Heart Association, Inc.