Cardiac catheterization complications

Minor to major bleeding complications may occur, most commonly at arterial access site for cardiac catheterization. 

The best explanation of this observation is that a large amount of contrast medium entered the vertebral artery and passed upwards, passing a defective blood-brain barrier. Similar complications have been described in other patients, sometimes with amnesia, after cardiac catheterization and angiography (SEDA-18, 444). 

Ablation of the myocardium using alcohol is another alternative to surgery. Septal ablation with alcohol results in the same type of outcomes as seen with myectomy. Long-term follow-up is limited because this procedure has been used for less than a decade. Since it is a percutaneous procedure (similar to cardiac catheterizations), it is being done more frequently than myectomy. There is some concern that the risk for arrhythmia-related cardiac events may increase following alcohol ablation. Long-term follow-up is needed to assess this risk. Complete heart block is a common complication of septal... 

Experience with thrombolysis in children is limited but the need for this procedure has increased because of the need to treat complications of cardiac catheterization and systemic arterial intervention. Agents used include urokinase and rtPA. Effective dose schedules for children have been extrapolated from adult studies. Coagulation and fibrinolysis are probably different in pediatrics, particularly in neonates. Plasminogen levels are known to be low in neonates, and it has been proposed that plasminogen or fresh plasma be given to enhance fibrinolytic therapy. Most centers favor iTPA, and this may be locally delivered via a selective catheter. Local low-dose therapy is unlikely to produce systemic... 

Complications related to pulmonary artery catheter insertion, maintenance, and removal include damage to vessels and organs during insertion, arrhythmias, infections, and thromboembolic damage. To avoid the complications associated with pulmonary artery catheterization, other less invasive tools were developed to obtain similar information. For example, cardiac output determinations have been made by Doppler, bioimpedance, dye, and ionic dilution techniques, although such measurements would not provide other data that are obtained routinely with pulmonary artery catheters (e.g., left-sided heart-filling pressure). Additionally, advances in... 

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