Usefulness of the internal jugular venous route for cardiac catheterization in children

Cardiac catheterization is an important tool in the diagnosis and management of heart disease in children. The femoral artery and vein are the usual routes of access for this procedure. In the past, use of the internal jugular vein for cardiac catheterization has been reserved for those children in whom femoral venous access was limited by obstruction, such as ileofemoral venous thrombosis or congenital absence of the hepatic portion of the inferior vena cava. Latson et al¹ reported use of this vein in 14 pediatric patients, in each for reasons of either inferior vena caval obstruction or the desire to maintain a central venous line after catheterization. At the Children's Hospital of Pittsburgh, the internal jugular vein has been used as a primary site for cardiac catheterization in patients undergoing endomyocardial biopsy after cardiac transplantation. This report describes our experience and technique.