000			02683nam a22003737a 4500
008			220222s20222022 xxu||||| |||| 00| 0 eng d
024			_a10.1016/j.carrev.2022.01.007 [doi]
024			_aS1553-8389(22)00007-0 [pii]
040			_aOvid MEDLINE(R)
099			_a35148947
245			_aTranshepatic access: Alternative approach for right heart catheterization and pulmonary angiography.
251			_aCardiovascular Revascularization Medicine. 2022 Jan 12
252			_aCardiovasc Revasc Med. 2022 Jan 12
253			_aCardiovascular revascularization medicine : including molecular interventions
260			_c2022
260			_fFY2022
260			_p2022 Jan 12
265			_saheadofprint
266			_d2022-02-22
501			_aAvailable in print through MWHC library: 2002 - present
520			_aPeripheral vascular disease, chronic large-bore venous access, and small body habitus can limit traditional venous access methods for right heart catheterization. We present a patient with chronic renal failure, small body habitus due to developmental delay, and multiple central vein stenoses due to chronic indwelling catheters and heparin-induced thrombocytopenia, who required right heart catheterization for workup of possible intracardiac shunt, pulmonary hypertension, and pulmonary embolism. We performed right heart catheterization and pulmonary angiography via transhepatic approach. The hepatic vein was accessed with a Chiba biopsy needle, and hepatic vein access was confirmed by contrast injection under fluoroscopy. A long 8-French sheath was advanced to the cavoatrial junction, and a balloon-tipped right heart catheter was used for pressure measurement, serial oxygen saturations, and angiography. Pulmonary pressures and angiography were normal, and there was no intracardiac shunt. Access-tract hemostasis was achieved with vascular plugs, embolization coils, and manual pressure. We demonstrate successful right heart catheterization and pulmonary angiography via transhepatic access. This is a valuable alternative access for patients with limited traditional options. Copyright (c) 2022. Published by Elsevier Inc.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aCardiovascular Disease Fellowship
657			_aCase Reports
700			_aBen-Dor, Itsik
700			_aWaksman, Ron
700			_aYang, Michael
790			_aBen-Dor I, Slack M, Waksman R, Yang M
856			_uhttps://dx.doi.org/10.1016/j.carrev.2022.01.007 _zhttps://dx.doi.org/10.1016/j.carrev.2022.01.007
942			_cART _dArticle
999			_c745 _d745