Abstract
Arterial thrombosis is a common and serious complication of percutaneous cardiac catheterization (cath) in children. A double blind study was therefore designed to test the value of heparin administered during cath in reducing this complication. One hundred and sixty-one unselected children > 1 year of age were studied. Prior to cath the pulse amplitude was measured in both legs using a pulse volume recorder, a quantitative oscillometer, (Surgery 72:873, 1972). Immediately after arterial canulation heparin (H) lmg/kg or a placebo (P) were administered. On the morning following cath the pulse amplitude in both legs was remeasured and a pulse volume index (PVI) calculated using the non-cath leg as a control. Patients in whom the cath leg was cold with poor capillary filling and absent arterial pulses 4 hours after cath were begun on systemic Heparinization (SH). If no improvement occurred within 48 hours embolectomy (E) was performed. Only 2/78 children in the H group had a PVI of < 50% compared to 10/83 in the P group (p<0.05). SH was required in 15/83 children in the P group and 3/78 in the H group (p<0.01). Embolectomy was performed in 7/83 children in the P group and none of 78 in the H group (p<0.03). We conclude that H administered during percutaneous cath is effective in preventing arterial thrombosis in children.
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