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Video networking of cardiac catheterization laboratories.

UNLABELLED: A video telecommunication network was established to transmit coronary images between a cardiac catheterization laboratory and a remote core laboratory. In 40 patients during interventional procedures, cine angiograms, live fluoroscopy, intravascular ultrasound studies, and images of the cath lab were transmitted in real time over a T1 line at 768 kbits/second at 15 frames/second. RESULTS: Measurements of angiographic and intravascular ultrasound parameters were very close between the original studies and the transmitted images. The telecommunication link up during the interventional procedures had a significant affect in 58% of cases.

Cardiac Catheterization↗

Pulmonary hypertension and foreign body granulomas in intravenous drug abusers. Documentation by cardiac catheterization and lung biopsy.

In this report we confirm the presence of pulmonary hypertension by cardiac catheterization in four intravenous drug abusers with biopsy-documented foreign body granulomas in the pulmonary vessels and interstitium. Each patient had a history of intravenous injections of alpha-sympathomimetic agents obtained from nasal inhalers. There agents may have contributed to the disease by constricting small vessels when simultaneously injected foreign bodies were passing through the vasculature of the lung. The severity of the pulmonary hypertension correlated well with the decrease in single breath diffusing capacity in each case. Pulmonary hypertension may contribute significantly to the increased morbidity and mortality observed in intravenous drug users.

Adult↗

Cardiac catheterization indications, techniques, interpretation, and complications.

In pediatric patients with congenital or acquired heart disease, cardiac catheterization and visual contrast studies provide a complete hemodynamic, functional, and anatomical picture of the patient's abnormality. The information obtained must be interpreted in light of the patient's history and clinical findings, together with other information obtained by noninvasive techniques. The procedure should be undertaken only after careful planning, yet the approach should be flexible, so that an alternate direction may be pursued should the unexpected be found. Each piece of information should be collated in step-wise fashion until the entire situation is clarified. Such procedures provide a wealth of information on which the cardiologist can base recommendations for continued medical management or surgical intervention.

Angiocardiography↗

The relationship between spontaneous coping strategies and perceived anxiety of patients undergoing cardiac catheterization.

Little is known about how patients spontaneously cope with the inherent stressors of the cardiac catheterization procedure. In this study, spontaneous coping strategies were identified and the relationship between coping strategies and anxiety throughout the procedure was examined. Data consisted of 62 patients' subjective ratings of anxiety, reported at 6 points during the procedure, and the coping strategies which were used at those times. The Coping with Invasive Medical Procedures (CIMP) Scoring System was developed and utilized to examine the relationships between coping and anxiety. At various points throughout the procedure, "control" and "hoping" were associated with high anxiety, while "passive coping" and "positive reframing" were associated with low anxiety. Patients who repeatedly changed coping strategies during the procedure experienced slightly less anxiety than those using a more consistent coping approach. The results are discussed with an emphasis on patient teaching.

Adaptation, Psychological↗

High-dose narcotic anesthesia using sufentanil in swine for cardiac catheterization and electrophysiologic studies.

A protocol for high-dose narcotic anesthesia using sufentanil by intravenous infusion was developed in swine undergoing cardiac catheterization and intracardiac electrophysiologic studies. In experiments involving cardiac conduction system ablation, nine swine received intramuscular ketamine, 33 mg/kg, and intramuscular acepromazine, 1.1 mg/kg, as premedication. An infusion of sufentanil (15 mcg/kg/h) was started followed by a loading dose of sufentanil (7 mcg/kg) given as a bolus intravenously. A continuous infusion of sufentanil (15-30 mcg/kg/h) was used for maintenance anesthesia. Since the development of this protocol, we have been able to achieve stable hemodynamics and cardiac rhythms for intracardiac electrophysiologic studies.

Anesthesia, Intravenous↗

Requirements on resolution of digital imaging equipment in the cardiac catheterization laboratory.

We evaluated the requirements on spatial resolution of digital imaging equipment in the cardiac catheterization laboratory. Fifty cinefilms of the heart as the biological object and one film of a lead-ladder-pattern as an objective test were used. The patient films were examined for the visibility of the left ventricular angiogram, coronary arterial tree, coronary artery lesions, branching of septal arteries and the number of septal arteries. All films were viewed three times: with a 625 line TV-system, with a 1249 line TV-system and with a cineprojector. It was found that two application areas with different demands on the spatial and temporal resolution can be distinguished: 1) low spatial resolution and high temporal resolution, e.g. left ventriculography; and 2) high spatial resolution and low temporal resolution, e.g. coronary arteriography. For the diagnostic assessment of the state of the coronary system, the spatial resolution provided by the 1249 line TV-system was sufficient. Exceeding this resolution by using cinefilm quality provided no additional diagnostic information. A frame rate lower than 50 frames per second for coronary arteriography seems possible.

Angiography↗

Vectorial characteristics of ventricular extrasystoles stimulated during cardiac catheterization.

Ventricular extrasystoles (VES) from different areas of the ventricular muscle mass were obtained by mechanical stimulation of inflow and outflow regions of the right ventricle (RV) and apical and basal portions of the left ventricle (LV) during cardiac catheterization. Cube system vectorcardiogram (VCG) patterns of VES from each location were analyzed to determine the specificity of vector orientation from each site. Transverse plane VCG distinguished between nonseptal LVES and RVES, while a combination of transverse and either sagittal or frontal planes permitted further localization of septal VES to inflow or outflow regions of the RV and apical and basal areas of the LV.

Adult↗