Abstract: AIM:To evaluate the efficacy and safety of chitosan dressings used for femoral hemostasis as an adjunct to manual compression in patients with structural heart disease undergoing cardiac catheterization.METHODS:Two hundred patients with structural heart disease undergoing cardiac catheterization were 1 ∶1 randomized for manual compression using regular or chitosan dressings.All patients were catheterized with a 6 Fr or 7 Fr sheath.Time to achieve hemostasis and incidence of minor and major bleeding were compared between groups.RESULTS:Time to achieve hemostasis was(4.0±1.5) and(7.6±2.5) min and the incidence of minor and major bleeding was 3% and 11%,respectively,in chitosan and regular dressings groups(P<0.05).Errhysis developed in 3%,and 3% of patients,respectively,in chitosan and regular dressings groups,but hematoma(n=4) and bleeding(n=4) were only observed in regular dressings group.Multiple regression models showed that the time to hemostasis was not associated with age,body mass index,blood pressure,blood platelet count and international normalized ratio in regular dressings group but was positively associated with mean blood pressure in chitosan dressings group.CONCLUSIONS:Compared with regular dressings,chitosan dressings significantly decrease the time to achieve hemostasis and lower the total incidence of hemorrhage.