INCIDENCE OF FEMORAL VEIN OCCLUSION AFTER CATHETER ABLATION IN CHILDREN - EVALUATION WITH MAGNETIC-RESONANCE ANGIOGRAPHY

Catheter ablation in children requires placement of multiple large fem oral venous sheaths and catheters. Magnetic resonance angiography (MRA ) was used to evaluate the effect of indwelling lines on femoral venou s blood Row. Between October 1993 and February 1994 a total of 17 pati ents scheduled for catheter ablation underwent venous MRA. Two-dimensi onal time-of-flight MRA was performed 12-70 hours after catheterizatio n on all patients. All patients received intravenous heparin during th e procedure and had aspirin therapy instituted after ablation. Eightee n catheter ablations and MRA studies were performed on the 17 patients (one patient underwent repeat ablation). There were 7 females and 10 males, with a mean age of 14.8 +/- 4.2 years (range 8-21 years). Patie nts had three venous sheaths inserted in the left femoral vein (5F, 6F , and 7F with external diameters measuring 1.7, 2.0, and 2.3 mm, respe ctively) and one sheath in the right femoral vein (7F), Four patients (22%) had altered venous now (two complete obstructions and two partia l obstructions) following catheterization. None of these patients expe rienced symptoms or complications. It was concluded that there is an i ncreased incidence (22%) of venous obstruction following catheter abla tion, but there are no related complications. Venous MRA provides a ra pid, noninvasive method for evaluating venous flow abnormalities and p ossibly detects patients al risk for complications.