Abstract

Introduction: Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed in cardiac surgery. The aim of this study was to compare left and right subclavian vein catheter placement via the infraclavicular approach in patients who undergo coronary artery bypass graft (CABG) surgery. Methods: This prospective, randomized clinical trial was performed in193 patients. The technique applied for cannulation was infraclavicular approach for both the right and the left sides. Subclavian vein of other side was attempted only when catheterization at initial side was unsuccessful at two attempts. The success and complication rates were compared for the two sides. Results: On193 patients, catheterization attempts were performed. Overall 177 catheterizations (91.7%) were successful during the first attempt, 105 (92.1%) on the right side and 72 (91.1%) on the left side. There was no significant difference between success rate and side of catheterization. Malposition of the catheter tip on the right side (9.6%) was significantly more than the left side (0%) (P= 0.003). The differences in other complications on two sides were statistically insignificant. Conclusion: Compared with the right side, insertion of the cannula on the left side resulted in fewer catheter tip misplacements. Incidence of cannulation failure and other complications were similar on both sides.

Highlights

  • Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed in cardiac surgery

  • Infraclavicular approach catheterization was attempted on the right side subclavian vein in 114 patients and on the left side in 79 patients

  • Three (1.6%) attempts at infraclavicular subclavian catheterisation failed on the both sides, all of these were initially unsuccessful on the right side (Table 2)

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Summary

Introduction

Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed in cardiac surgery. The aim of this study was to compare left and right subclavian vein catheter placement via the infraclavicular approach in patients who undergo coronary artery bypass graft (CABG) surgery. The technique applied for cannulation was infraclavicular approach for both the right and the left sides. The success and complication rates were compared for the two sides. Overall 177 catheterizations (91.7%) were successful during the first attempt, 105 (92.1%) on the right side and 72 (91.1%) on the left side. Conclusion: Compared with the right side, insertion of the cannula on the left side resulted in fewer catheter tip misplacements. Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed by anesthesiologist in cardiac surgery.

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