Femoral venous haemostasis in children and young adults using the 'figure-of-eight' suture technique

Acta Cardiol. 2022 Sep;77(7):626-631. doi: 10.1080/00015385.2021.1973769. Epub 2021 Sep 7.

Abstract

Aim: The aim of our study was to evaluate the safety and efficiency of the 'figure-of-eight' suture among children and young adults with congenital heart defects who underwent interventional procedures, in patients with structurally normal hearts who underwent electrophysiological study and in haemodynamically impaired children and newborns. We also reported a novel femoral haemostasis method in patients with a central catheter by modifying the 'figure-of-eight' suture around the catheter for haemorrhage control.

Method: Between 2015 and 2018, a total of 100 'figure-of-eight' sutures were performed in 90 patients (48 males, 42 females) where the median age was 12.5 years (minimum 3 days, maximum 22 years). The procedures were diagnostic angiography (n = 6), radiofrequency and/or cryoablation (n = 7) and interventional procedures (n = 87).

Result: Haemostasis was achieved in 89 of 90 patients. Haemostasis could not be achieved in one malnourished patient due to lack of subcutaneous tissue. There were no major complications. A bullous skin lesion and minor bleeding were the only complications seen in two patients. A central catheter was inserted in eight patients using the modified 'figure-of-eight' suture technique.

Conclusion: The 'figure-of-eight' suture is a safe and effective method for femoral venous haemostasis in patients who require large sheaths for procedures, in those using high-dose heparin and in haemodynamically unstable children who need cardiac catheterisation.

Keywords: Femoral venous haemostasis; congenital heart disease.

MeSH terms

  • Catheter Ablation* / adverse effects
  • Child
  • Cryosurgery* / adverse effects
  • Female
  • Femoral Vein / surgery
  • Hemorrhage / etiology
  • Humans
  • Infant, Newborn
  • Male
  • Suture Techniques / adverse effects
  • Sutures / adverse effects
  • Treatment Outcome
  • Young Adult