Syed Aqeel Hussain, Shahab Naqvi, Iftikhar Ahmed, Umair Younis, Kamal Saleem, Syed Muzaffar Hasan.
Percutaneous trans-jugular technique for continuous perioperative monitoring of intra-cardiac and pulmonary artery pressures during cardiac surgery for congenital heart disease.
J Pak Med Assoc Jan ;62(9):924-8.

Objective: To observe the safety of trans-jugular pressure-monitoring catheter insertion at a tertiary care teaching hospital in Rawalpindi, Pakistan. Methods: The observational study was carried out at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from January 1, 2004 to March 31, 2010. All patients electively scheduled to undergo cardiac surgery for congenital heart disease who had percutaneous trans-jugular pressure monitoring catheters inserted peri-operatively were included in the study. Dedicated Medtronic® 3 Fr pressure monitoring catheters were passed through internal jugular vein using the modified Seldinger. The patients were followed up during the hospital stay for complications related to catheter insertion/removal. Data was analysed using SPSS version 15. Results: Of the 572 patients in the study, the catheters were ultimately positioned with the tips in the pulmonary artery in 447 (78.14%)patients, right ventricle 54 (9.44%) patients, left atrium in 52 (9.09%), and in both pulmonary artery and left atrium in 19 (3.32%) patients. Duration of pressure monitoring from all the chambers was 53±19 hours post-operatively. Transient and self-limiting atrial or ventricular ectopic beats were noticed in 163 (27.58%) patients during insertion. Catheter was found to be non-functional in 12 (2.03%) patients. Only one (0.16%) patient experienced recurrent tachyarrhythmia which required the withdrawal of catheter. Conclusion: Insertion of trans-jugular pressure monitoring catheters during cardiac surgery for congenital heart disease is a safe and reliable technique.

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