Hello,

This from one of our staff interventional radiologists:

No right answer on this one. You want the tip of the catheter to lie in the distal SVC or proximal/mid right atrium. However, different companies measure their own catheter lengths differently. Hence, I think you need to identify whatever is the average catheter one would use in the majority of patients, and stick with that one for all but the biggest and smallest patients. You can always adjust the position of the cuff in the tunnel to take individual patient size into account. Without fluoroscopy, I guess you have no options for assessing tip position until the post procedure CXR, unless you can see the tip on cardiac echo.

Dr. Jordan Weinstein

Thanks Dr.Weinstein for the answer. I guess we'll have to wait till we get some form of fluoroscopy before we can attempt the procedure.