Comparison of the complications between left side and right side subclavian vein catheter placement in patients undergoing coronary artery bypass graft surgery

Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed in cardiac surgery. The aim of this study was to compare left and right subclavian vein catheter placement via the infraclavicular approach in patients undergoing coronary artery bypass graft surgery.

This prospective, randomized clinical trial was performed in 193 patients. The technique of cannulation was the same for both the right and the left sides included infraclavicular approach. If catheterization of the subclavian vein was unsuccessful after 2 attempts,the other side subclavian vein was attempted. The success and complication rates were compared in both sides.

In 193 patients, catheterization attempts were performed, in whom 177catheterizations (91.7%) were successful during the first attempt, 105 (92.1%) on the right side and 72 (91.1%) on the left side. There were no significant differences between success rate and side of catheterization. Malposition of the catheter tip on the right side (9.6%) was significantly more(p =0.003) than the left side (0%). There were no significant differences between the incidence of the other complications on the two sides.

Compared with the right side, insertion of the cannula on the left side resulted fewer catheter tip misplacements although both sides showed the same incidence of cannulation failures and other complications.