Cardiorespiratory Emergencies, Hospital General de México 'Dr Eduardo Liceaga', Mexico City, Mexico; Pulmonary Circulation Clinic, Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Doctorate Program in Biomedical Sciences, Postgraduate Unit. National Autonomous University of Mexico, Mexico City, Mexico.
Curr Probl Cardiol. 2024 Feb;49(2):102136. doi: 10.1016/j.cpcardiol.2023.102136. Epub 2023 Oct 18.
Right heart catheterization (RHC) represents the gold standard diagnostic approach for pulmonary hypertension (PH). Historically, the complication rates of RHC are known to be low. The study aimed to evaluate the indications for performing RHC and the occurrence of adverse events related to the procedure in patients > over 70 years of age in a Mexican Tertiary Care Center. We conducted a retrospective single-center registry from July 2017 to July 2022. A total of 517 patients with suspected PH underwent RHC. The cohort included patients <70 (n = 427) and ≥70 years of age (n = 90). Adverse events were classified as major (eg, death, pneumothorax, and carotid artery puncture) and minor (eg, atrial arrhythmia, superior vena cava dissection, incidental arterial puncture, and local hematoma). Appropriate hemodynamic parameters were recorded. No report of major adverse events in the entire cohort. In the <70 years age group, 9 minor events, and 3 minor events were in the ≥70-year-old patients (P < 0.0001). There was a significant difference in the measurement of mean pulmonary artery pressure (mPAP) between the <70 years old vs ≥70 years old (P < 0.001); there was a significant difference in right atrial pressures: 4.71 ± 3.14 mmHg in the <70-year-old vs 4.07 ± 1.94 mmHg for the ≥ 70-year-old group (P = 0.014). Our findings suggest that RHC can be safely performed in patients aged ≥70 years using different vascular access routes without significant major complications.
右心导管检查（RHC）是肺动脉高压（PH）的金标准诊断方法。历史上，RHC 的并发症发生率已知较低。本研究旨在评估在墨西哥三级护理中心>70 岁的患者中进行 RHC 的适应证以及与该程序相关的不良事件的发生情况。我们进行了一项回顾性单中心登记研究，时间为 2017 年 7 月至 2022 年 7 月。共有 517 例疑似 PH 患者接受了 RHC。该队列包括<70 岁（n=427）和≥70 岁的患者（n=90）。不良事件分为主要（如死亡、气胸和颈动脉穿刺）和次要（如房性心律失常、上腔静脉夹层、偶然动脉穿刺和局部血肿）。记录了适当的血流动力学参数。整个队列均未报告重大不良事件。在<70 岁年龄组中，9 例为轻度事件，3 例为≥70 岁患者的轻度事件（P<0.0001）。<70 岁组与≥70 岁组之间平均肺动脉压（mPAP）的测量值存在显著差异（P<0.001）；右心房压力存在显著差异：<70 岁组为 4.71±3.14mmHg，≥70 岁组为 4.07±1.94mmHg（P=0.014）。我们的研究结果表明，使用不同的血管入路，RHC 可以安全地在≥70 岁的患者中进行，而不会出现重大的主要并发症。
