Author + information
- Jacob Abraham, MD∗ (, )
- Rebecca S. Lewis, MN,
- Lian Wang, MS,
- Kateri J. Spinelli, PhD,
- Josh Remick, MD,
- Jeff Paulsen, MD and
- Jay Chappell, MD
- ↵∗Providence St. Vincent Heart and Vascular Institute, 9205 SW Barnes Road, Suite 495, Portland, Oregon 97225
The CardioMEMS pressure sensor (St. Jude Medical, St. Paul, Minnesota) was shown in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial to reduce the risk of hospitalization in patients with symptomatic heart failure (1). The device gained U.S. Food and Drug Administration approval for implantation using a percutaneous femoral venous approach. The right internal jugular (IJ) vein is commonly accessed for venous procedures and offers the advantage of immediate post-procedure mobilization. Additionally, this approach may be safer than femoral access in obese patients or patients receiving anticoagulation. Placement of a CardioMEMS device through the IJ was recently reported in a patient with severe tricuspid regurgitation and morbid obesity who was not a candidate for femoral access (2).
Here we report our experience delivering the CardioMEMS pressure sensor through the right IJ in a larger cohort of patients at 2 implantation centers. Deployment through the IJ was successful in 20 of 21 patients (95%). One patient was converted from IJ to femoral approach due to severe dilation of the right atrium and right ventricle, impeding access. Deployment times from the IJ approach were similar to those from the femoral approach and, despite high use of anticoagulants at the time of procedure, did not result in any periprocedural bleeding (Table 1). Of the 12 outpatients in the IJ group, all had same-day discharge, whereas 24 of 26 outpatients (92%) in the femoral patients had same-day discharge (p = ∼1.0).
Our experience demonstrates the safety and feasibility of IJ access for CardioMEMS implantation. Compared to the femoral approach, the IJ approach is associated with high rates of same-day discharge and no bleeding complications in our cohort. These results support broader use of IJ access for the CardioMEMS implantation procedure.
Please note: The authors have reported that they have no relationships relevant to the contents of this paper to declare.
- American College of Cardiology Foundation