Immediate complications and late sequelae of arterial catheterization in children with congenital heart disease.

Early vascular complications and late sequelae are reported in relation to 195 left heart catheterizations, 125 performed by brachial arteriotomy (BA), and 70 by percutaneous femoral artery puncture (FAP) with the Seldinger technique. Vascular complications occurred in 25 patients, 11 requiring surgical intervention, which was successful in restoring normal circulation in all. The rate of complications was higher after FAP in children 6 years old or less, while after BA the rate was significantly higher in patients of 2 years or older. In patients under 2 years, brachial artery suture repair resulted in more complications than ligation, but the cases were not randomized. Late follow-up of 101 catheterizations (35 FAP, and 66 BA, of which 38 were ligated and 28 sutured) included clinical evaluation, Doppler pressure measurements, and a comparison of the length and bone development of the catheterized and non-catheterized limbs. All these have indicated an absence of any serious late sequelae in this group 6 months to 9 years (average 4 years) after catheterization.