ILIAC VENOUS THROMBOSIS IN INFANTS AND CHILDREN AFTER CARDIAC-CATHETERIZATION

Thrombosis of the lower abdominal portion of the inferior vena cava, iliac or femoral vein (IVT) developed in 22 patients after cardiac catheterization. All patients had at least 1 previous study from 1 day-11 mo. old (mean, 2 mo.) and 7 had 2 catheterizations before discovery of IVT. Transposition of the great arteries was the most common defect associated with IVT (12/22, 55%). From 1-7 catheter changes were made during the time of venous cannulation (mean, 105 min). No clinical evidence of IVT was present immediately after the preceding cardiac catheterization. The discovery of significant IVT usually necessitated the use of a vein from the arm to complete the cardiac catheterization. IVT was associated with previous balloon atrial septostomy using either a Fogarty or Rashkind septostomy catheter in 13/22 patients (59%). Of the patients, 86% had balloon catheters or a Swan-Ganz catheter used during a previous study. The potential development of IVT should be considered, especially in cyanotic infants and small children in whom balloon catheters are used.