A SAFE TECHNIQUE TO MONITOR PULMONARY-ARTERY PRESSURE DURING AND AFTER PEDIATRIC CARDIAC-SURGERY

Pulmonary hypertensive crises (PHC) are a recognized cause of sudden c linical deterioration and death after the surgical correction of conge nital heart disease. In this study, pulmonary artery pressure was moni tored in 84 children (at high risk to develop PHC) aged nine days to f ive years (mean 1.4 years) using monitoring lines inserted percutaneou sly through the right internal jugular vein (IJV). Success rate of pla cement of the catheter tip in the pulmonary artery (PA) in the pre-inc ision period was not high (7%) but all catheter-tips were successfully placed in the PA by the surgeon before right atrial closure prior to separation from cardiopulmonary bypass. Complications related to the t echnique were transient ventricular/atrial arrhythmias (78.5%) during insertion and slipping or coiling (20%) of the catheter in the right v entricle. Complications relating to the IJV puncture included carotid arterial puncture(1) and pneumothorax(1). No other complications were encountered. Monitoring lines inserted percutaneously and guided into the pulmonary artery during surgery provide a safe and practical way o f monitoring pulmonary artery in infants and children at risk of posto perative pulmonary hypertensive crises.