Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cardiac Catheterization”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed1992

Rates of cardiac catheterization, coronary angioplasty and open-heart surgery in adults in Canada.

OBJECTIVE: To determine the rates of and waiting lists for cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA) and open-heart surgery in adults in Canada between Apr. 1, 1988, and Mar. 31, 1989. DESIGN: Mail survey. PARTICIPANTS: The directors of all 48 adult cardiac catheterization laboratories and the chiefs of all 33 adult cardiovascular surgery programs in Canada. MAIN RESULTS: A total of 61,116 cardiac catheterization procedures were performed, a rate of 236 per 100,000 population. The mean waiting times for elective procedures were weighted to reflect more accurately the differences between centres in the number of patients awaiting the procedures. The mean wait for elective cardiac catheterization was 8.5 weeks. There were 10,097 PTCA procedures done, a rate of 39 per 100,000 population. The mean wait for elective PTCA was 11.0 weeks, the longest wait occurring in Quebec (15.4 weeks). A total of 16,240 open-heart procedures were performed, a rate of 63 per 100,000 population. The mean wait for elective open-heart surgery was 22.6 weeks, the longest wait occurring in Quebec and British Columbia (more than 32 weeks). The rates for all three procedures were much lower in Canada than in the United States. CONCLUSIONS: The results suggest that the cumulative wait for coronary angiography and PTCA or open-heart surgery may lead to major losses of productivity, delayed rehabilitation and reduced probability of return to previous levels of productivity. Regular collection of data such as ours should help to understand better the resources required for these specialized cardiac procedures.

Adult↗
PubMed1997

Local venous thrombosis after cardiac catheterization.

Pulmonary embolism is a rare but life-threatening complication of cardiac catheterization. Underlying deep venous thrombosis (DVT) is often not detectable clinically. To determine the true incidence of DVT the authors prospectively studied 450 consecutive patients (29% women, 71% men, mean age: fifty-eight years) undergoing a diagnostic cardiac catheterization. Patients were examined clinically and by duplex sonography with a high-resolution (5 or 7.5 MHz) transducer before and twenty-four hours after catheterization before mobilization. Duplex sonography excluded complete proximal DVT in all patients. Only partial occluding thrombi (pDVT) were detected in 11 (2.4%) patients. The thrombi were always localized at the puncture site. In 2 patients a difference was found in the circumferences of the legs, but no other clinical signs of DVT were seen. With use of continuous wave (cw) Doppler sonography, only 3 of these 11 patients (27%) showed a spontaneous (s) sound. Phlebography was performed in 4/11 patients (36%). In 2 patients the diagnosis was confirmed; in 1 patient extravenous compression was assumed, and the other demonstrated a normal-appearing phlebography at the time of investigation. Logistic regression analysis yielded a 3.5 times higher risk for developing a pDVT if a venous puncture was performed in addition to arterial puncture. Furthermore a 9.8 times higher risk was found if more than one venous puncture was necessary. During the follow-up no patient developed clinical signs of pulmonary embolism. The results of this study demonstrate that DVT is a rare complication of cardiac catheterization (0/450 patients), but pDVT occurred in 2.4%. Risk factors for pDVT are the venous puncture itself and multiple puncture attempts. Clinical relevance of pDVT remains to be determined.

Cardiac Catheterization↗
PubMed1990

Effect of cardiac catheterization on renal function.

Sensitive acute renal clearance methodology was used to investigate the incidence of radiocontrast-induced nephrotoxicity in patients undergoing cardiac catheterization. Patients at the University of Oklahoma Teaching Hospitals scheduled for elective cardiac catheterization had their creatinine clearance measured on the day preceding and the day following their procedure. All patients had a serum creatinine concentration lower than 175 mumol/l. The creatinine clearance was calculated from the mean of four consecutive 30-minute renal clearance periods obtained in the fasted state during water loading. The change in renal function following the catheterization was evaluated. There was no significant change in the creatinine clearance after the cardiac catheterization (Ccr 101.5 +/- 6.4 ml/min before and 111.6 +/- 7.4 ml/min after the procedure). A decrease in Ccr exceeding 25% occurred in 1 of 23 subjects (4.3%. Patient age, presence of diabetes, and volume of contrast agent were not adverse risk factors. The results suggest a low risk of nephrotoxicity in low-risk patients undergoing elective cardiac catheterization, even when very sensitive measures of glomerular filtration rate are utilized.

Acute Kidney Injury↗
PubMed1979

Incidence of new pulmonary perfusion defects after routine cardiac catheterization.

The incidence of pulmonary perfusion defects after routine cardiac catheterization was assessed in 57 patients by comparing ventilation-perfusion lung scans obtained before and 1 day after catheterization. Patients were prospectively randomized to two groups, one in which right heart catheterization was performed using an antecubital venous cutdown procedure and one in which the percutaneous femoral vein approach was used. Seven patients (12 percent) had new postcatheterization perfusion defects consistent with pulmonary emboli. These patients did not differ significantly from patients without new defects in clinical characteristics, duration of catheterization, hemodynamic variables or route of right heart catheterization. The data suggest that pulmonary embolism may be a more common complication of routine cardiac catheterization than previously appreciated.

Adult↗
PubMed1998

Echocardiography and cardiac catheterization in the preoperative assessment of ventricular septal defect in infancy.

BACKGROUND: Cardiac catheterization is commonly performed before repair of ventricular septal defect (VSD) in infancy. No study has addressed the accuracy of echocardiography alone in defining all of the important anatomic features in this population. METHODS: Consecutive infants undergoing VSD repair between 1991 and 1995 (n = 156) were reviewed. The number of additional VSDs and the presence of commonly associated lesions were recorded for each technique and compared with a reference standard consisting of a combination of surgical findings plus postoperative echocardiography and clinical findings. The associated lesions were right ventricular muscle bundles, subaortic ridge, and persistent ductus arteriosus. RESULTS: The sensitivity and specificity of echocardiography in the detection of additional VSDs was 60% and 99% compared with 53% and 97% for cardiac catheterization and 73% and 96% for both techniques. These differences were not statistically significant. No differences were seen in the detection of commonly associated lesions. CONCLUSION: Routine preoperative cardiac catheterization for infants with a primary diagnosis of VSD is probably no longer justified.

Cardiac Catheterization↗
PubMed1994

Should all patients undergoing cardiac catheterization or percutaneous transluminal coronary angioplasty receive oxygen?

BACKGROUND: Supplemental oxygen is routinely administered to patients with acute coronary syndromes. The risk of significant morbidity during cardiac catheterization or coronary angioplasty has been well described; however, to our knowledge, the need for routine oxygen supplementation in these patients has not been investigated. METHODS: In phase 1, we prospectively studied 142 patients undergoing diagnostic cardiac catheterization (n = 94) or percutaneous transluminal coronary angioplasty (PTCA) (n = 48) to determine the incidence of procedure-related hypoxemia (pulse oximetry derived oxygen saturation [SpO2] < 90 percent of > 1 min duration) while breathing room air (RA). In phase 2, 134 patients undergoing diagnostic cardiac catheterization (n = 78) or PTCA (n = 56) were randomly allocated to breathe either RA or supplemental oxygen (O2, 6 L/min by nasal cannula) to determine the effect of oxygen administration on procedure-related hypoxemia. Oximetry results were compared with pertinent clinical and procedural data that might predispose patients to develop hypoxemia. RESULTS: Phase 1--Moderate to severe hypoxemia occurred in 36 percent (34/94) of patients undergoing diagnostic catheterization and in 56 percent (27/48) of patients undergoing PTCA. In the diagnostic catheterization group, there were a total of 25 episodes of moderate hypoxemia (SpO2 85 to 89 percent) lasting 4.0 +/- 4.3 min and 11 episodes of severe hypoxemia (SpO2 < 85 percent) of greater duration, 11.7 +/- 7.5 min (p < 0.008). In the PTCA group, there were 24 episodes of moderate hypoxemia and six episodes of severe hypoxemia lasting 4.8 +/- 4.3 min and 8.2 +/- 3.8 min, respectively. A history of chronic lung disease was associated with hypoxemia (p < 0.05) in the diagnostic group. In addition, 11 patients undergoing diagnostic catheterization who had baseline SpO2 < 95 percent all developed hypoxemia during the procedure. In this subset of patients, there was a higher incidence of cigarette smoking (p = 0.02), chronic lung disease (p = 0.04), higher left ventricular diastolic pressure (p = 0.02), and lower ejection fraction (p = 0.002) when compared with the 83 remaining patients undergoing diagnostic catheterization with a baseline SpO2 > 95 percent. Phase 2--Oxygen therapy was associated with a reduction in the incidence of hypoxemia from 42 percent to 5 percent (RA vs O2, p < 0.001) in the diagnostic catheterization group and 39 percent to 11 percent (RA vs O2, p < 0.03) in the PTCA group. CONCLUSIONS: Significant hypoxemia is a common finding among patients undergoing cardiac catheterization or angioplasty despite the absence of predictive risk factors. Severe and prolonged hypoxemic episodes occurred in 10 percent (14/142, phase 1) of patients breathing room air. Patients undergoing diagnostic catheterization with history of chronic lung disease or a baseline SpO2 < 95 percent are at high risk to develop moderate-severe hypoxemia. Oxygen therapy significantly reduced the incidence and severity of procedure-induced hypoxemia in both groups. Our data support the use of both pulse oximetry and oxygen supplementation in patients undergoing cardiac catheterization and PTCA.

Angioplasty, Balloon, Coronary↗
PubMed2004

Sex differences in outcomes after cardiac catheterization: effect modification by treatment strategy and time.

CONTEXT: Studies comparing outcomes of cardiac care in women vs men yield various results, with some suggesting worse outcomes for women and others suggesting equivalent outcomes. OBJECTIVE: To determine whether extent of coronary disease, treatment strategy, and follow-up time influence the risk of death in women vs men among patients who have had cardiac catheterization. DESIGN, SETTING, AND PATIENTS: We studied a large inception cohort by using detailed clinical data from a registry of 37 401 patients undergoing cardiac catheterization in Alberta, Canada, from 1995-2000, with follow-up through December 31, 2001. MAIN OUTCOME MEASURES: The risk of death for women vs men was assessed for all patients combined and then in analyses stratified by degree of coronary anatomic risk and by treatment strategy (no revascularization, percutaneous coronary intervention [PCI], coronary artery bypass graft [CABG] surgery). The latter analysis included a graphic assessment of the changing relative risk over time for women vs men. RESULTS: Women had higher 1-year mortality than men did (5.6% vs 4.6%; P<.001). However, stratified analyses demonstrated that sex differences in risk occurred only early after catheterization and were most apparent among patients undergoing revascularization. The early risk-adjusted relative risks for women vs men were elevated at 3.49 (95% confidence interval [CI], 1.95-6.24) for CABG surgery and 2.38 (95% CI, 1.48-3.83) for PCI on day 1 after catheterization, with a subsequent decrease in relative risk over time to equivalence in risk between sexes before 1 year. CONCLUSIONS: Sex-based differences in death rates after cardiac catheterization are time- and treatment-specific. This finding may at least partially explain the discrepancies in results from earlier studies on sex differences in outcomes of cardiac care.

Aged↗
PubMed2006

Impact of on-site cardiac catheterization on resource utilization and fatal and non-fatal outcomes after acute myocardial infarction.

BACKGROUND: Patterns of care for acute myocardial infarction (AMI) strongly depend on the availability of on-site cardiac catheterization facilities. Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes. METHODS: We identified all patients (n = 35,289) admitted with a first AMI in the province of Quebec between January 1, 1996 and March 31, 1999 using population-based administrative databases. Medical resource utilization and non-fatal and fatal outcomes were compared among patients admitted to hospitals with and without on-site cardiac catheterization facilities. RESULTS: Cardiac catheterization and PCI were more frequently performed among patients admitted to hospitals with catheterization facilities. However, non-invasive procedures were not used more frequently at hospitals without catheterization facilities. To the contrary, echocardiography [odds ratio (OR), 2.04; 95% confidence interval (CI), 1.93-2.16] and multi-gated acquisition imaging (OR, 1.24; 95% CI, 1.17-1.32) were used more frequently at hospitals with catheterization, and exercise treadmill testing (OR, 1.02; 95% CI, 0.91-1.15) and Sestamibi/Thallium imaging (OR, 0.93; 95% CI, 0.88-0.98) were used similarly at hospitals with and without catheterization. Use of anti-ischemic medications and frequency of emergency room and physician visits, were similar at both types of institutions. Readmission rates for AMI-related cardiac complications and mortality were also similar [adjusted hazard ratio, recurrent AMI: 1.02, 95% CI, 0.89-1.16; congestive heart failure: 1.02; 95% CI, 0.90-1.15; unstable angina: 0.93; 95% CI, 0.85-1.02; mortality: 0.99; 95% CI, 0.93-1.05)]. CONCLUSION: Although on-site availability of cardiac catheterization facilities is associated with greater use of invasive cardiac procedures, non-availability of catheterization did not translate into a higher use of non-invasive tests or have an impact on the fatal and non-fatal outcomes available for study in our administrative database.

Acute Disease↗
PubMed1991

Determination of severity of valvular aortic stenosis by Doppler echocardiography and relation of findings to clinical outcome and agreement with hemodynamic measurements determined at cardiac catheterization.

To determine the relation of Doppler findings to clinical outcome and the agreement between Doppler and cardiac catheterization in the assessment of aortic stenosis (AS) severity, 510 consecutive patients with suspected AS studied in our laboratory were analyzed. Adequate echocardiographic and Doppler examinations were obtained in 498 patients or 98% of the population. Clinical data were available for analysis in 497 patients. In 160 patients, Doppler demonstrated an aortic valve area less than or equal to 0.75 cm2 or a peak jet velocity greater than or equal to 4.5 m/s consistent with critical AS. In the subgroup with cardiac catheterization (n = 105), Doppler was 97% accurate. Aortic valve replacement or balloon valvuloplasty was performed in 109 patients, 106 of whom were symptomatic. Noncritical AS was detected by Doppler in 327 patients, with 95% accuracy in the subgroup with cardiac catheterization (n = 133). Aortic valve replacement was performed in 15 patients with symptoms of AS and with valve areas assessed by Doppler to be between 0.76 and 0.80 cm2 or with peak jet velocities greater than 3.5 m/s. In 20 patients, aortic valve replacement was performed because of moderate to severe aortic regurgitation, and in 11 elderly (greater than 70 years old) patients with valve areas between 0.80 and 1.0 cm2, valve replacement was performed at the time of coronary artery bypass surgery in an attempt to prevent the need for a repeat surgical procedure in the future. These observations allow the following conclusions. In the symptomatic patient with critical or near critical AS by Doppler, cardiac catheterization does not provide additional information beyond that provided by Doppler.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Noninvasive evaluation of interventricular pressure gradient across ventricular septal defect: a simultaneous study of Doppler echocardiography and cardiac catheterization.

Simultaneous continuous-wave Doppler echocardiography and left- and right-sided cardiac pressure measurements were performed during cardiac catheterization in 64 patients with a congenital ventricular septal defect (VSD). The peak-to-peak pressure gradient across the VSD on cardiac catheterization ranged from 0 to 109 mm Hg (61 +/- 31.7 mm Hg). The peak shunt velocity and peak pressure gradient across the VSD on Doppler ultrasound imaging ranged from 0.96 to 5.21 m/sec (3.75 +/- 1.16 m/sec) and from 4 to 105 mm Hg (62 +/- 29.8 mm Hg), respectively. Doppler measurements of the peak interventricular pressure gradient correlated well with measurements obtained by cardiac catheterization (r = 0.98, standard error of estimate = 6.3 mm Hg, p less than 0.001). Doppler ultrasound imaging yielded information comparable to that obtained by catheterization and provided an accurate method of measuring the pressure gradient across the VSD, which is a useful parameter for the assessment of pulmonary artery systolic pressure in patients with a VSD, without a left or right ventricular outflow tract obstruction.

Adolescent↗
PubMed1992

The preponderance of posterior circulatory events is independent of the route of cardiac catheterization.

BACKGROUND AND PURPOSE: Central nervous system complications of cardiac catheterization are most often attributed to embolic events that occur at the time of catheter manipulation. Nevertheless, the reason that over 50% of these events are localized to the posterior circulation remains unexplained. One potential explanation offered for this preponderance is the use of the brachial artery approach. In this report, we examined the relation between the route of catheterization and central nervous system complications. SUMMARY OF REPORT: We retrospectively analyzed all central nervous system complications that occurred after cardiac catheterization through a femoral route at our institution over a 3 1/2-year period. Thirteen patients were identified as having central nervous system complications. Using defined criteria, posterior circulatory events still accounted for at least 54% of central nervous system complications. CONCLUSIONS: The preponderance of posterior circulatory events is apparently independent of the route of catheterization. Furthermore, given the array of neurological symptoms and their often complete resolution, we feel it is unlikely that embolism is the sole pathophysiological mechanism involved in these events.

Aged↗
PubMed1992

Splenic infarction: a complication of cardiac catheterization.

Patients with extensive atherosclerosis are at increased risk of developing embolic complications during cardiac catheterization. We describe a 51-year-old man with unstable angina and bilateral leg claudication who developed fever and right upper abdominal pain shortly after cardiac catheterization. Liver-spleen scintigraphy demonstrated a wedge-shaped filling defect compatible with splenic infarction, and serial scans performed over a period of five months showed resolution of this finding. Splenic infarction tends to be under-diagnosed, and physicians should be aware of this potentially serious complication of cardiac catheterization.

Cardiac Catheterization↗
PubMed2000

Retinal cholesterol emboli during diagnostic cardiac catheterization.

Retinal embolism is a highly infrequent complication of cardiac catheterization of thrombotic, lipidic, and calcific etiology. We provide the first reported clinical case of retinal embolism caused by cholesterol crystal without systemic adverse effects as a severe complication of diagnostic cardiac catheterization. Cathet. Cardiovasc. Intervent. 51:323-325, 2000.

Blindness↗
PubMed2001

Trends in cardiac catheterization laboratories in the United States.

The Society for Cardiac Angiography and Interventions has periodically published a Directory of Cardiac Catheterization Laboratories in the United States. All known catheterization laboratories are surveyed and certain operational characteristics are queried. These surveys, in 1983, 1987, 1993, 1995 and 1998, have demonstrated a 2.5 fold increase in cardiac catheterization laboratories since 1983, corresponding increases in numbers of physicians that perform procedures, and in the numbers of procedures performed, reflecting advances in cardiovascular medicine and technology. These surveys have also documented the evolution of interventional techniques, and a shift away from film based imaging, to digitally based methods. These data provide a substrate for consideration of national cardiovascular objectives and planning of future resource allocation by cardiovascular physicians and their colleagues.

Cardiac Catheterization↗
PubMed1999

Evaluation of 3-hour ambulation post cardiac catheterization.

There is much variation in the length of immobilization for patients post cardiac catheterization. While it is generally agreed that a period of time on bedrest is necessary to prevent post procedural complications, the optimal duration remains unknown. The purpose of this study was to evaluate the effects of 3-hour ambulation post cardiac catheterization with a 7 french (F) arterial catheter on bleeding, hematoma formation, and vascular complications. Retrospective chart data were gathered for a period of 8 months for patients who were on the traditional 5-hour ambulation protocol, and prospective data were gathered for a period of 7 months for patients who received the 3-hour protocol. A total of 880 patients were included in the study, with 472 in the 5-hour ambulation group and 408 in the 3-hour ambulation group. The overall incidence of delayed bleeding and hematoma formation for the 15 month study period was 19.1%, with no occurrence of vascular complications in either group. Patients who received the 3-hour ambulation protocol experienced a significantly lower rate of bleeding and hematoma formation (13%) than patients who received the 5-hour ambulation protocol (24.4%) (p < 0.001). Ambulating patients 3 hours post cardiac catheterization with a 7F catheter was found to be safe, and thus has the potential to decrease hospital length of stay, as well as increase patient comfort.

Adolescent↗
PubMed1991

Septic complications after cardiac catheterization and percutaneous transluminal coronary angioplasty.

Septic complications after cardiac catheterization and percutaneous transluminal coronary artery angioplasty are distinctly uncommon. However, we have recently treated nine patients with sepsis and life-threatening complications after cardiac catheterization alone or after catheterization and subsequent percutaneous transluminal coronary angioplasty. The common denominator in all patients was either repeat puncturing of the ipsilateral femoral artery or leaving the femoral artery sheath in for 1 to 5 days after the procedure. Two patients died as a direct result of their septic complications. One death occurred in a patient in whom bacterial endocarditis with congestive heart failure developed, and the other patient had a large retroperitoneal hematoma that became secondarily infected. Infected aneurysms that were successfully treated developed in three patients. Our study suggests that colonization of the needle tract by skin flora predisposes to septic complications if repeat arterial punctures are required or if a femoral artery sheath is left in place for more than 24 hours. Patients in whom sepsis develops after these procedures should be initially treated with antibiotics effective against gram-positive organisms. CT scanning or angiography should be considered for patients with persistent sepsis, septic emboli, and abdominal or flank pain. Infected aneurysms require resection or ligation because of the propensity of these aneurysms to rupture.

Aged↗
PubMed2004

Racial differences in cardiac catheterization as a function of patients' beliefs.

OBJECTIVES: We examined racial differences in cardiac catheterization rates and reviewed whether patients' beliefs or other variables were associated with observed disparities. METHODS: We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. RESULTS: There were few demographic differences between White and African American patients in our sample. African Americans were less likely than Whites to undergo cardiac catheterization. African Americans were more likely than Whites to indicate a strong reliance on religion and to report racial and social class discrimination and were less likely to indicate a generalized trust in people but did not differ from White patients on numerous other attitudes about health and health care. Neither sociodemographic or clinical characteristics nor patients' beliefs explained the observed disparities, but physicians' assessments of the procedure's importance and patients' likelihood of coronary disease seemed to account for differences not otherwise explained. CONCLUSIONS: Patients' preferences are not the likely source of racial disparities in the use of cardiac catheterization among veterans using VA care, but physicians' assessments warrant further attention.

Black or African American↗