ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Ultrasound-guided femoral vascular access in adult congenital heart disease patients undergoing catheter ablation on uninterrupted oral anticoagulation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundData on ultrasound-guided vascular access (UGVA) to reduce vascular access complications in adult congenital heart disease (ACHD) patients undergoing catheter ablation (CA) on uninterrupted oral anticoagulation (OAC) are limited.
objectiveComparison of UGVA to a standard approach with regard to vascular access complications in ACHD patients.
methodsWe retrospectively analyzed 477 consecutive ACHD patients (52% male, mean age 46 ± 14 years) with simple (n = 166), moderate (n = 133), and complex (n = 178) congenital heart disease (CHD) who underwent 639 CA procedures for atrial tachycardia or fibrillation between 2014 and 2024. UGVA (243 patients, 271 ablations) was compared to a conventional approach (234 patients, 368 ablations) regarding vascular access complications under uninterrupted OAC (DOAC or VKA).
resultsAccess was obtained via the femoral vein (n = 321), both femoral vein and artery (n = 311), or jugular vein with femoral artery (n = 7). UGVA significantly reduced overall vascular access complications compared to the standard approach (4.1% vs. 13.5%; p < 0.001). Major complications occurred only in the conventional group (n = 4; AV fistula = 2, retroperitoneal hematoma = 2; p = 0.086). Minor complications-hematomas > 5 cm, small AV fistulas treated conservatively, or pseudoaneurysms treated by compression or ultrasound-guided thrombin injection-were also significantly lower with UGVA (4.1% vs. 12.5%; p < 0.001).
conclusionsUGVA significantly decreases vascular access complications in ACHD patients undergoing CA on uninterrupted OAC and may be advantageous for routine use in clinical practice.
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