The study aim was to evaluate present practice of maintaining PICC line patency in pediatric heart failure patients receiving continuous inotropes by comparing one cohort receiving low dose continuous heparin with one receiving no heparin. A case control retrospective chart review compared the two cohorts on duration of patency (measured in days) and need for thrombolytic agents. Median duration of patency for the heparin group was 24 days versus 16 days for the no heparin group (p = 0.07). Use of thrombolytic agents was 28% in the heparin group compared to 50% in the no heparin group (p = 0.08). Although not statistically significant, findings were clinically significant and supportive of current practice.