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 415 records · Page 23Linked to original sources
PubMed1991

Transesophageal echocardiographic monitoring of interventional cardiac catheterization in children.

Transesophageal echocardiography was used prospectively in 22 children scheduled for interventional cardiac catheterization (9 with pulmonary valvuloplasty, 5 with aortic valvuloplasty, 1 with pulmonary angioplasty, 2 with aortic angioplasty, 2 with patent ductus arteriosus occlusion and 3 with Mustard baffle dilation) to determine its potential value as a monitoring technique. The patients ranged in age from 0.9 to 14.6 years (mean 5.4) and in weight from 9.5 to 49.2 kg (mean 21.1). Studies were completed in all patients without complications. Preintervention studies provided important new information in two patients, leading to cancellation of the planned procedure. Major contributions of transesophageal monitoring included 1) a real time assessment of catheter placement across either atrioventricular valve and the aortic valve during balloon valvuloplasty; 2) immediate assessment of aortic valve and aortic wall morphology during balloon dilation; and 3) detailed morphologic and hemodynamic information together with enhanced catheter guidance during Mustard baffle dilation. After pulmonary valvuloplasty, partial chordal rupture of the tricuspid valve was documented in one patient. In two patients, balloon catheter position was modified according to the transesophageal findings. The assessment of changes in pulmonary valve morphology and transcatheter occlusion of a patent ductus arteriosus was not enhanced by single-plane transesophageal monitoring. Pulsed wave Doppler studies contributed additional information in the assessment of immediate hemodynamic changes after interventional procedures. Transesophageal echocardiography is a new important guiding and monitoring technique during interventional cardiac catheterization procedures in children. It can provide additional real time imaging information, immediate identification of complications and assessment of hemodynamic changes.

Adolescent↗
PubMed2000

Reflex sympathetic dystrophy following transbrachial cardiac catheterization.

We experienced a rare case of complication by reflex sympathetic dystrophy (RSD) following transbrachial cardiac catheterization which may have been caused by poorly executed hemostasis using a hemostatic device. The symptoms of RSD markedly limited the patientOs daily work activities. Although the transbrachial approach is a useful procedure for cardiac catheterization, interventionalists should be aware that RSD may cause serious complications.

Aged↗
PubMed1984

[Prevention of postoperative infection following cardiac catheterization in pediatric field. Study of air-borne bacteria in X-ray room and evaluation of an antibiotic used for prevention of postoperative infection].

As part of preventive measures against postoperative infection following cardiac catheterization in infants with cardiac diseases, especially falling bacteria in X-ray room was studied. Moreover, a synthetic penicillin, ticarcillin (TIPC), was used as preventive antibiotic against postoperative infections due to falling bacteria which probably contaminate the air in the X-ray examination room, and the efficacy and side effects of the drug were observed. As result, coagulase-negative Staphylococcus was detected the most, followed by Micrococcus and then by fungus. The number of these 3 organisms corresponded to 90.3% of the total number of falling bacteria detected during operation. The number of falling bacteria during operation was 5.1 times larger than that before operation. Taking into account normal flora of skin, falling bacteria present in the X-ray room and causative organisms of bacterial endocarditis, TIPC was administered to 30 cases intravenously 5 times at a dose of 30 mg/kg every 8 hours for the purpose of preventing possible postoperative infections following cardiac catheterization. The drug was effective to prevent such infections in all cases. No side effects were noted in any case, in peripheral blood and hepatic function tests and other observations.

Adolescent↗
PubMed1993

Cardiac catheterization and coronary angiography using 5 French preformed (Judkins) catheters from the percutaneous right brachial approach: a comparative analysis with the femoral approach.

This study describes a method for the performance of cardiac catheterization using 5 French preformed Judkins catheters from a percutaneous right brachial approach, and compares that technique to the more traditional percutaneous right femoral approach with 6 French catheters. One hundred consecutive patients requiring diagnostic left heart catheterization and selective coronary angiography were randomized according to femoral versus brachial arterial technique. Procedural efficiency, radiation exposure, and diagnostic film quality favored the femoral approach, while patient comfort, hemostasis time, time to ambulation, and decreased need for post-procedure nursing care favored the brachial approach. No differences were identified in complications. Cardiac catheterization from a right brachial artery percutaneous approach with 5 French preformed catheters has both advantages and disadvantages when compared with a more traditional femoral approach with 6 French catheters. Multiple factors should be considered before selecting an approach to diagnostic cardiac catheterization and each patient should be individually evaluated for determination of the optimal technique.

Brachial Artery↗
PubMed2006

Effects of nifedipine on systemic and pulmonary vascular impedance in subjects undergoing cardiac catheterization.

Nifedipine 10 mg, administered sublingually to 12 patients following diagnostic cardiac catheterization, caused reduction in systemic resistance, and change of impedance together with alteration in contour of the ascending aortic and left ventricular pressure waves. The substantial reduction in ascending aortic and left ventricular systolic pressure with nifedipine occurred despite an increase in stroke volume and cardiac output, and was associated with similar reductions in mean pressure and indices of wave reflection. In the same patients, there were no significant changes in pulmonary vascular resistance or impedance, nor in pulmonary artery or right ventricular pressure pulse contour. For the systemic circulation, as with nitroglycerin and nitroprusside, reduction in wave reflection appears to be an important factor in the drug's action and for its beneficial effects on cardiac load in the treatment of angina pectoris, systemic hypertension and left ventricular failure. Thus the observed effects of nifedipine were attributed to vasodilatation of the systemic arteries and arterioles.

Administration, Sublingual↗
PubMedDate not supplied

Evidence against the widespread use of angiography of noncoronary arteries during coronary artery angiography and cardiac catheterization.

PURPOSE: Although the most widely used screening techniques for extracardiac atherosclerotic distributions are noninvasive, in patients undergoing coronary arteriography, the question as to whether angiography of extracardiac arteries at the time of cardiac catheterization is really effective or if it should be considered malpractice is still open. We sought to determine the safety and real usefulness of angiography of extracardiac arteries performed by trained invasive cardiologists during cardiac catheterization. METHODS: Medical records of all patients undergoing combined coronary and noncoronary angiography between May 1998 and December 2002 were retrospectively reviewed. Moderate to severe arterial stenosis (>50% stenosis), vessel occlusion, aneurysmal, or severe ectasia were noted as significant angiographic findings. RESULTS: Two hundred and seventy patients (165 males, mean age = 67.7+/-9.2 years, mean serum creatinine = 1.1+/-0.8 mg/dl) underwent combined cardiac catheterization and angiography of extracardiac arteries following specific indications. Significant findings were reported in 66 (24.4%) patients. Logistic regression analyses revealed three-vessel coronary artery disease [CAD; odds ratio (OR)=9.917; 95% confidence interval (CI) = 2.2 to 43.8; P = .002) and hypercholesterolemia (OR = 2.851; 95% CI=1.03 to 7.9; P = .044) to be independent predictors of extracardiac atherosclerotic involvement. Complications rate was negligible. The detection of significant angiographic findings led to endovascular treatment in 37.8% and surgical vascular repair in 33.3% of cases. CONCLUSIONS: Angiography of extracardiac arteries at the time of coronary angiography appears justified only in patients with specific indications, multivessel CAD, and hypercholesterolemia.

Aged↗
PubMed2000

Effective doses to patients from paediatric cardiac catheterization.

The Council Directive of the European Communities 97/43/Euratom requires dose assessment, especially for X-ray examinations of children and if high doses to the patient are involved. Both these aspects apply in cardiac catheterization and angiocardiography of children. Effective doses are a good indicator of radiation risk, particularly for leukaemia. Effective doses have been determined for 2114 infants and children undergoing cardiac catheterization from 1984 to 1996 at the University Hospital in Essen. Conversion factors (effective dose/dose-area product) were calculated based on direct dose-area product measurements for posteroanterior (PA) and lateral (Lat) projections as well as on patient records and examination details. The factors are calculated for eight age groups of children, taking into account the X-ray tube voltage for fluoroscopy and cine-film sequences, with and without zoom mode. Frequency distributions are presented for 2114 patients, for dose-area product, number of angiographic examinations (each combined with one cine-film sequence both PA and Lat) and for calculated effective doses. Highest effective doses are found in newborns (18.0 mSv and 6.5 mSv 90th and 50th percentiles, respectively) compared with adolescents of 15-21 years (8.0 mSv and 3.0 mSv 90th and 50th percentiles, respectively). Effective dose for cardiac catheterization is highest for newborns, in spite of lowest measured dose-area products, because the decreased value of the conversion factors overcompensates for the increase of dose-area product with age. This is especially important because of the higher tumour risk for equal effective dose for young children compared with adults.

Adolescent↗
PubMed1982

Oxygen consumption in adult patients during cardiac catheterization.

The determination of cardiac output by the Fick principle requires the quantitation of the arteriovenous oxygen (O2) content difference across the pulmonary bed and the O2 consumption. Since a correct measurement of O2 consumption may be difficult, an assumed value is sometimes substituted into this equation. Despite this practice, there is no appropriate reference standard for O2 consumption applicable to the adult catheterization laboratory. Therefore, we determined O2 consumption in 108 patients (69 men and 39 women, mean age, 49 years) at the time of catheterization by multiplying the arteriovenous content difference by the indicator dilution cardiac output, thereby eliminating errors related to the collection and analysis of the timed collection of expired air. O2 consumption index (O2 consumption/m2 of body surface area) averaged 126 +/- 26 ml/min/m2 (mean +/- SD), but there was wide variability(65-250 ml/Min/m2). O2 consumption was not affected by patient age or sex but was lower in those who were mildly sedated before catheterization (sedated, 121 +/- 22 ml/Min/m2; nonsedated, 132 +/- 28 ml/min/m2; p = 0.023). Thus, O2 consumption varies greatly among adults at the time of cardiac catheterization, so that any attempt at estimating this variable is fraught with major potential error.

Adult↗
PubMed1999

A comparison of U.S. and Canadian cardiac catheterization practices in detecting severe coronary artery disease after myocardial infarction: efficiency, yield and long-term implications.

OBJECTIVES: We sought to compare U.S. and Canada's post-myocardial infarction (MI) cardiac catheterization practices in the detection of severe coronary artery disease (CAD). BACKGROUND: Little is known about the efficiency with which the aggressive post-MI catheterization strategy observed in the U.S. detects severe CAD compared with the more conservative strategy observed in Canada. METHODS: From the U.S. and Canadian patients who had participated in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Arteries trial (n = 22,280, 11.5% Canadian), we examined the frequency of in-hospital cardiac catheterization, the prevalence of severe CAD observed at catheterization (diagnostic efficiency) and the total number of MI patients with severe CAD identified (diagnostic yield). RESULTS: The rate of catheterization in the U.S. was more than 2.5 times that in Canada (71% vs. 27%, respectively, p < 0.001). With identical prevalences of severe CAD at catheterization (17%) in the two countries, the higher frequency of catheterization in the U.S. resulted in the identification of more than two and a half times as many cases of severe CAD compared with Canada (12 severe CAD cases identified per 100 post-MI patients in the U.S., vs. 4.6 per 100 in Canada). If considered in isolation, we estimated that these differences in severe disease detection might effect a small long-term survival advantage in favor of the U.S. strategy (estimated 5.0 lives saved per 1,000 MI patients). CONCLUSIONS: Canada's more restrictive post-MI cardiac catheterization strategy is no more efficient in identifying severe CAD than the aggressive U.S. strategy, and may fail to identify a substantial number of post-MI patients with high risk coronary anatomy. The long-term impact of these differences in practice patterns requires further evaluation.

Canada↗
PubMed1995

Occupational exposure in pediatric cardiac catheterization.

Radiation doses to staff involved with pediatric cardiac catheterization were measured using thermoluminescent dosimeters in 18 procedures. The average doses to the lens and thyroid, and the effective dose per procedure to the main operating physicians was 88, 180, and 8 microSv, respectively; to assistant physicians, 23, 51, and 2 microSv; and to technicians, 23, 27, and 2 microSv. In some procedures, the dose to the technician's hand approached 1,500 microSv. The doses received by physicians were proportional to cineangiographic time but with no correlation with integrated currents. The number of procedures which may be performed in a year by individual staff members was estimated to be 430 and 2,780 procedures for physicians and assistants, respectively. It was suggested that the front of the neck is an adequate position for the dosimeter to measure doses during pediatric catheterization.

Adolescent↗
PubMed2006

A mathematical model for patient skin dose assessment in cardiac catheterization procedures.

A mathematical model has been developed for the assessment of patient skin doses from cardiac catheterization procedures. This uses exposure and projection data stored in the DICOM image files. Since these contain only information about the acquisition runs, a correction is needed to estimate and include the contribution from fluoroscopy. Maximum skin doses calculated by the model were found to correlate well with those measured on Kodak EDR2 film. Three methods for including the contribution from fluoroscopy were investigated, and all successfully identified patients receiving skin doses in excess of 1 Gy. It is hoped to automate this tool for routine assessment of skin doses in our cardiac catheterization laboratories.

Cardiac Catheterization↗
PubMed2003

Feasibility of simplifying balloon mitral valvuloplasty by obviating left-sided cardiac catheterization using on-line guidance with transesophageal echocardiography.

STUDY OBJECTIVES: The purpose of this study was to evaluate the feasibility of simplifying balloon mitral valvuloplasty through the obviation of left-sided cardiac catheterization using on-line guidance with transesophageal echocardiography in patients with mitral stenosis. SETTING: A tertiary care medical center DESIGN: Patients who were eligible for balloon mitral valvuloplasty were enrolled into the study if they had no evidence of ischemic heart disease. Sixty-six patients (50 women and 16 men) met the criteria. Balloon mitral valvuloplasty was performed through right-sided cardiac catheterization using adjunctive on-line guidance with transesophageal echocardiography. Left-sided catheterization was obviated. MEASUREMENT AND RESULTS: Balloon mitral valvuloplasty was smoothly performed in all patients. Successful dilatation (postprocedural mitral orifice area, > 1.5 cm(2); or increment in mitral orifice area, >or= 50%) was achieved in 50 patients (75.8%). The mean (+/- SD) mitral orifice area increased from 1.08 +/- 0.23 cm(2) to 1.68 +/- 0.39 cm(2) (p = 0.0000). There were no in-hospital deaths, no patients with cardiac tamponade, or complications necessitating an emergency cardiac operation. The mean fluoroscopy time was 7.6 +/- 3.9 min, and the total procedure time was 50.2 +/- 15.0 min. CONCLUSION: It is feasible and safe to simplify balloon mitral valvuloplasty by obviating left-sided cardiac catheterization in selected patients with mitral stenosis using adjunctive on-line guidance with transesophageal echocardiography.

Adult↗
PubMed1999

Femoral neuropathy following cardiac catheterization for balloon mitral valvotomy.

Femoral neuropathy is a very rare complication of cardiac catheterization. We report an adult female who developed femoral neuropathy after undergoing cardiac catheterization through femoral vein for balloon mitral valvotomy. Neuropathy was confirmed by electromyography and nerve conduction studies and the patient showed spontaneous recovery over a course of 6 months. Use of prolonged digital pressure for post-procedural hemostasis is implicated as possible etiology. Such complications can be prevented by minimising the procedural time, avoiding injury to the vessels and maintaining optimal posture of patient's thigh by limiting abduction and external rotation of hip.

Adult↗
PubMed2004

Quantification of functional mitral valve regurgitation in patients with congestive heart failure: comparison of electron-beam computed tomography with cardiac catheterization.

OBJECTIVES: We sought to determine the agreement between electron-beam computed tomography (CT) and cardiac catheterization for the quantification of mitral regurgitation and to evaluate their association with echocardiographic assessment. MATERIAL AND METHODS: Fifty patients with congestive heart failure were examined both by electron-beam CT and catheterization to calculate mitral regurgitation volume and fraction based on the difference between the left ventricular stroke and aortic flow volume. The severity of regurgitation was also compared with visual assessment by echocardiography (grade, 0-4+). RESULTS: The mean values for the mitral regurgitation volume and fraction did not differ significantly between electron-beam CT and catheterization (mean differences: 0.2 mL/m2 and -0.9%, P > 0.05 each, limits of agreement: -14.0 to 14.4 mL/m2 and -26.3 to 24.5%, respectively) and showed a good correlation (r = 0.79 and r = 0.76, respectively; P < 0.05 each). Good levels of correlation were observed between echocardiographic severity grading and quantitative measurements of regurgitation volume and fraction, which were somewhat better between echocardiography and electron-beam CT (rS = 0.78 and rS = 0.84, respectively; P < 0.05 each) than between echocardiography and catheterization (rS = 0.72 and rS = 0.81, respectively; P < 0.05 each). CONCLUSION: Our results suggest that electron-beam CT allows for quantification of mitral valve regurgitation with similar accuracy as cardiac catheterization. Measurements with both modalities correlated well with the results of echocardiographic assessment.

Adult↗
PubMed1998

Variability of radiation output dynamic range in modern cardiac catheterization imaging systems.

Automatic exposure control (AEC) is one of the most important characteristics for optimizing cardiac catheterization imaging; this allows the X-ray system to provide sufficient radiation output under a variety of clinical conditions so that a satisfactory image is obtained. AEC was assessed in 97 cardiac catheterization laboratories using a standard set of phantoms. Three different copper attenuators were used to simulate three patient sizes. As magnification increased, many systems had limited dynamic range and were unable to increase radiation output. With increasing atttenuator thickness, the problem worsened. With the thickest attenuator and largest magnification (4.5"-5.0" FOV), 60% of systems could not achieve the typical 70% increase in exposure while 20% were unable to increase radiation output at all.

Body Burden↗
PubMed1978

Why does a child with a normal heart undergo cardiac catheterization?

Children who have no heart disease at cardiac catheterization have usually been referred because of signs or symptoms on the background of a basal flow murmur. The ECG and chest x-ray are sometimes spurious and may lead to catheterization. Advances in noninvasive testing are helping to screen this population. Only in rare instances should the risks involved with catheterization be taken in a child with a basal flow murmur and no other evidence of heart disease.

Adolescent↗