Abstract 14436: Right Interval Jugular Access for Cardiomems™ Implantation is Safe, Effective, and Fast

Document Type

Abstract

Publication Date

11-5-2018

Publication Title

Circulation

Keywords

cards

Abstract

Introduction: The CardioMEMS™ pulmonary artery pressure sensor is FDA approved for insertion via the femoral vein. The right internal jugular vein (IJ) is an alternative access route used frequently by heart failure cardiologists. The IJ approach obviates the need for patient immobilization for hemostasis and has been shown to be effective in a single center study.

Hypothesis: CardioMEMS™ IJ access has comparable efficacy and safety to femoral access, while allowing for shorter discharge time.

Methods: This was a retrospective analysis of patient and procedural data from 10 providers at 4 high-volume centers that routinely implant the CardioMEMS™ sensor via IJ approach. Outcomes including fluoroscopy time, deployment time, case time, case complications, time to discharge, and rates of same day discharge were compared between IJ and femoral approaches using Wilcoxon rank sum test for continuous variables and Chi-square or Fisher’s exact test for categorical variables. Regression analyses were conducted to identify and control for confounders.

Results: Median age was 69 years (range 30-91) and 48% of patients were female. Seventy two (33%) patients had femoral access and 148 (67%) had IJ access; demographics were similar between the groups. Unadjusted outcomes showed IJ cases finished 17 minutes faster, discharged 19 hours faster overall and 4 hours faster for outpatient cases (Table 1). Complications and 30 day mortality were low and did not differ between cohorts. After adjusting for confounders, the median time to case completion for the IJ approach was 12% (95% CI: 3-21%) shorter than the femoral approach (p=0.01). Confounder-adjusted outcomes showed outpatients who had femoral approach were 96% (95% CI: 67-99%) less likely to have same day discharge than outpatients who had IJ approach (p<0.001).

Conclusions: In a multi-center study, we found that IJ access for CardioMEMS™ implant is associated with shorter procedure time and higher rates of same-day discharge.

Clinical Institute

Cardiovascular (Heart)

Department

Center for Cardiovascular Analytics, Research + Data Science (CARDS)

Department

Cardiology

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