The use of balloon-tipped pulmonary artery catheters in children undergoing cardiac surgery.

Percutaneous pulmonary artery (PA) catheterization via the internal jugular vein was studied in 58 children undergoing cardiac surgery. Central venous cannulation, which succeeded in all children, was associated with a 10% incidence of inadvertent carotid artery puncture without untoward effects. Successful placement of the PA catheter was achieved in 47 (92%) of the 51 children in whom it was anatomically possible to enter the pulmonary artery at the time of the catheterization. Four (8%) catheter tip cultures were positive. The PA catheter yielded important information in diagnosing low cardiac output, severe pulmonary hypertension or residual cardiac defects in 27 (47%) children. Twenty (35%) children had critical therapeutic interventions because of the PA catheter information. The high yield of important data and the low incidence of major complications seem to justify the use of percutaneously inserted PA catheters in children with an increased operative risk.