A new technique in advancing the catheter from the left atrium to the left ventricle

A technique is described by which a catheter is advanced from the left atrium to the left ventricle during a right heart catheterization via the leg. A loop in the catheter is created by the clockwise twisting of the catheter while it is gently pushed against the posterior left wall of the left atrium. The catheter is then pulled back and is twisted counter-clockwise. The catheter has to be soft, and biplane fluroscopy is required. During a 16-month period 162 consecutive infants and children had heart catheterization performed, during which a pediatric NIH catheter was passed to the left atrium. The loop-technique was attempted in 95 patients and was successful in 66 patients. One or two attempts were usually sufficient. No complications were encountered apart from two brief episodes of bradycardia. The technique is easy to perform with a reasonable success rate. It seems most useful in infants in whom 5F catheters are used.