Learning Objective 1: Understand the commonly experienced complications of Right Heart Catheterisation and their implications.
Learning Objective 2: Understand the importance of clinical database interrogation to monitor complication rates and ensure benchmarking of program performance.
Methods: Review of 1429 RHCs between January 2008 and June 2012. Patients were not fasted, anti coagulation therapy was not ceased and patients were not routinely admitted.
581 patients records were reviewed by medical staff, the last 848 involved interrogation of a clinical database.
Adverse events were defined as either events caused by the RHC, which required intervention to treat or prevent an adverse outcome, were medically significant, resulted in an unexpected admission, or were life threatening. (Definition A)
Or in addition prolonged a procedure, required abandonment of the procedure or otherwise impacted on program resources. (Definition B)
Chi square analysis determined the significance of anti coagulation on bleeding complications in the first 581 patients.
Results: Between 2008 and 2009 581 procedures were performed. Adverse event rate (Def A)was 4.3%.
Chi square analysis of bleeding complications and warfarinisation on bleeds gave p=0.11
Between 2010 and 2012 a further 848 RHCs were assessed through interrogation a clinical database and revealed an event rate of between 4.8% (Def A) and 7.2% (Def B).
We describe acute musculoskeletal, respiratory, haemodynamic and anaphylactic events.
Conclusion: Being un fasted had no effect on adverse events and allowed real life haemodynamic data to be collected. Bleeding complications were minor and being anti-coagulated made no difference to the event rate in the first 581 patients. (p=0.24). Difficulty obtaining access and a knotted catheter support the need for flouroscopy and ultrasound guidance in high volume services.