In thirty-two neonates with congenital heart disease, who had failed umbilical venous catheter placement using traditional, "blind" techniques, real-time ultrasound-guidance and liver pressure were used to replace malpositioned umbilical venous catheters and achieve successful placement at the inferior cavoatrial junction. Real-time ultrasound guidance has become standard of care for central venous line placement in children outside the neonatal period but is a new and emerging technique for umbilical vessel catheterization. We sought to use real-time, point-of-care ultrasound to achieve successful central umbilical venous cannulation in patients for whom traditional blind placement techniques had failed. [Extracted from the article]