Percutaneous trans-jugular technique for continuous perioperative monitoring of intra-cardiac and pulmonary artery pressures during cardiac surgery for congenital heart disease

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.