SAFETY OF CARDIAC-CATHETERIZATION VIA PERIPHERAL VASCULAR GRAFTS

There are few data concerning the complications and technical difficul ties encountered when cardiac catheterization is performed using perip heral bypass grafts for vascular access. All cardiac catheterizations performed at our institution from January 1, 1984 to April 1, 1991 wer e retrospectively reviewed to assess the in-hospital clinical outcomes in patients who had arterial access for catheterization achieved via prosthetic graft puncture. Seventeen procedures had percutaneous punct ure of a vascular graft from a total of 2,929 arterial catheterization s performed. The interval from graft placement to catheterization was 7.5 +/- 1.1 years. Arterial sheaths were employed in all cases and cor responded to the catheter size, with 5F systems used in 53% and 7F or larger systems used in the remaining patients. No intraprocedural or p ostprocedural complications were recognized. Technical difficulties we re limited to the inability to selectively cannulate a nondominant rig ht coronary artery in 1 patient. We conclude that percutaneous introdu ction of an arterial sheath and left heart catheterization via remotel y implanted vascular bypass grafts is not associated with an increased risk of procedural complications or technical difficulties.