Complications of right heart catheterization in patients ≥ 70 years of age with suspected pulmonary hypertension: Experience from a tertiary care center.

INTRODUCTION: Right heart catheterization (RHC) represents the gold standard diagnostic approach for pulmonary hypertension (PH). Historically, the complication rates of RHC are known to be low.

OBJECTIVES: The study aimed to evaluate the indications for performing RHC and the occurrence of adverse events related to the procedure in patients > over 70 years of age in a Mexican Tertiary Care Center.

METHODS: We conducted a retrospective single-center registry from July 2017- July 2022. A total of 517 patients with suspected PH underwent RHC. The cohort included patients < 70 (n = 427) and >= 70 years of age (n = 90). Adverse events were classified as major (e.g., death, pneumothorax, and carotid artery puncture) and minor (e.g., atrial arrhythmia, superior vena cava dissection, incidental arterial puncture, and local hematoma). Appropriate hemodynamic parameters were recorded.

RESULTS: No report of major adverse events in the entire cohort. In the <70 years age group, nine minor events, and three minor events were in the ≥70-year-old patients (p<.0001). There was a significant difference in the measurement of mean pulmonary artery pressure (mPAP) between the <70 years old versus ≥70 years old (p< 0.001); there was a significant difference in right atrial pressures: 4.71 ± 3.14 mmHg in the < 70-year-old versus 4.07 ± 1.94 mmHg for the ≥ 70-year-old group (p=0.014).

CONCLUSIONS: Our findings suggest that RHC can be safely performed in patients aged ≥ 70 years using different vascular access routes without significant major complications.