PURPOSE: To determine if chest radiographs are necessary following ultrasound guided right heart catheterization (RHC) performed without fluoroscopy by experienced physicians in an outpatient setting.
METHODS: We performed a retrospective review of our systemic sclerosis database for patients who underwent RHC for a clinical concern for pulmonary hypertension. All procedures were performed in the outpatient setting. Patients were monitored for at least one hour during the procedure by a critical care nurse and the performing physicians. We personally reviewed all post-catheterization radiographs for any signs of complications and reviewed the final radiolgy reports.
RESULTS: Forty-one patients underwent forty-four procedures which met inclusion criteria for the study. In this cohort, there were no pneumothoraces. The most common abnormal catheter-associated finding was peripheral placement with the recommendation to withdraw the catheter in five studies.
CONCLUSIONS: In this retrospective review of patients with systemic sclerosis undergoing outpatient RHC, there were no pneumothoraces complicating this procedure. We conclude that when RHC is performed by experienced physicians using ultrasound guidance and with no clinical signs of pneumothoraces, routine use of post-catheterization chest radiograph may be unnecessary.
CLINICAL IMPLICATIONS: Routine chest radiographs following ultrasound guided outpatient right heart catheterization are not clinically indicated.
DISCLOSURE: The following authors have nothing to disclose: David Guidry, Boaz Markewitz, Tracy Frech, Allen Sawitzke, Nathan Hatton
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