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At least 685 records · Page 38Linked to original sources
PubMed1984

Incidence of new focal pulmonary emboli after routine cardiac catheterization comparing the brachial to the femoral approach.

The incidence of pulmonary perfusion defects after routine cardiac catheterization was assessed in 56 patients by comparing ventilation-perfusion (V/Q) lung scans obtained before and 1 day after catheterization. Patients were prospectively randomized in two groups, one in which the brachial approach was performed using an antecubital cutdown procedure, and one in which the percutaneous femoral approach was used. None of the patients with the brachial approach had any ventilation-perfusion mismatch on the V/Q scan; however, three patients (8.3%) with the femoral approach did. These two groups did not differ significantly in clinical characteristics, duration of catheterization, and hemodynamic variables. The data suggest that pulmonary emboli postcardiac catheterization is more frequent in the femoral than the brachial approach. Furthermore, since those pulmonary emboli are mostly asymptomatic, their clinical recognition would be underestimated.

Brachial Artery↗
PubMed1993

Resolution of coronary ischemic syndrome due to dislodgement of intraluminal thrombus during diagnostic cardiac catheterization.

Dislodgement of an intraluminal coronary thrombus occurred in a patient with unstable angina during diagnostic cardiac catheterization. The thrombus propagated into the systemic circulation without clinical manifestation of embolism. The procedure rendered the patient asymptomatic. The case illustrates the role of intraluminal coronary thrombus in unstable angina.

Angina, Unstable↗
PubMedDate not supplied

Improving outcomes for pediatric patients in the adult cardiac catheterization laboratories.

Critical care nurses are facing a new dilemma: caring for pediatric patients undergoing invasive cardiac procedures in the adult cardiac catheterization and electrophysiology laboratories. This article presents nursing standards of practice for the pediatric patient in these clinical settings. These standards promote consistency in nursing care and direct clinical practice toward achieving positive patient outcomes.

Adult↗
PubMedDate not supplied

Building a pediatric cardiac catheterization laboratory and conference room: design considerations and filmless imaging.

Building or upgrading a dedicated pediatric cardiac catheterization laboratory is an expensive and elaborate undertaking complicated by long-standing biases based on adult laboratory requirements. Optimal design for the needs of pediatric cardiologists and their patients has never been published. This communication discusses these design issues in the context of pediatric needs and offers potential solutions. It also attempts to educate the reader on the basics of digital imaging and its advantages over cine film technology; and it explains how to achieve optimal filmless data acquisition and subsequent display for pediatric cardiac management.

Cardiac Catheterization↗
PubMed1977

Severe papillary muscle dysfunction substantiated by atrial pacing during cardiac catheterization.

A patient experienced episodic pulmonary edema accompanying nocturnal angina pectoris. The symptoms were provoked at cardiac catheterization by atrial pacing. Simultaneous onset of chest pain, shortness of breath, and sudden appearance of a large V wave in the pulmonary artery wedge pressure contour confirmed acute mitral valve regurgitation. Rapid reversal of these changes after nitroglycerin administration supported "papillary muscle dysfunction" as the explanation for these hemodynamic changes.

Aged↗
PubMedDate not supplied

Post-cardiac catheterization femoral fistula corrected by ultrasound-guided compression.

We present a case of post-cardiac catheterization femoral fistula diagnosed by color and pulsed Doppler sonography and treated by ultrasound-guided compression. We avail ourselves of the case to review the echo Doppler semiology of the different types of arteriovenous fistulas with an emphasis on the functional analysis of the dialysis accesses. We also stress the therapeutic options in front of undesirable shunts.

Aged↗
PubMed1995

Multimedia cardiac catheterization record document system.

In this paper, we present the design and implementation of a multimedia cardiac catheterization record (CCR) system. A traditional CCR contains medical report, electrocardiograms, X-ray images, and possibly video sequences for angiograms. The physicians found it difficult to access and manage these multimedia information easily. Current advances in multimedia technology has made possible the authoring, storage and presentation of these medical information in a systematic and easily-accessible way. This paper discusses the background and rationale that led to the design and implementation of a cost-effective multimedia medical document system framework and prototype.

Cardiac Catheterization↗
PubMed2002

Plasma lidocaine concentrations after local anesthesia of the groin for cardiac catheterization.

This study aimed to investigate serum lidocaine concentrations after subcutaneous infiltration of the groin for cardiac catheterization. One hundred twenty-six patients for planned heart catheterization received five different dosages (5-25 ml) of lidocaine 2% for local anesthesia of the groin in a randomized manner. All of them received an arterial sheath and 13 received both an arterial sheath and a venous sheath for right heart catheterization. Blood samples were taken before as well as 15, 30, and 120 min after subcutaneous application of the drug. Although in 33 patients with an arterial sheath (no venous sheath) excessive doses of lidocaine 2% (20-25 ml) were used, neither symptoms of intoxication nor toxic plasma levels were observed. However, in patients receiving an additional venous sheath, toxic plasma levels were obtained in a third of the cases. One of them showed symptoms of intoxication.

Adult↗
PubMed1986

Two-dimensional/Doppler echocardiography and its relationship to cardiac catheterization for diagnosis and management of congenital heart disease.

The impact of echocardiography on cardiac catheterization in an individual patient with congenital heart disease depends on a number of factors, including the availability of an echocardiographer who is experienced in congenital heart disease and of appropriate "state of the art" equipment, and willingness of clinicians and surgeons to accept echocardiographic data. The latter is influenced by factors such as completeness of the echocardiographic data, familiarity with tomographic cardiac anatomy, and the perceived risk of an invasive procedure. The combined use of echocardiography and catheterization will have an increasing impact on the management of these patients, significantly altering the indications and extent of a catheterization procedure. This will lead to a more goal-directed examination. The relationship between catheterization and 2-D/Doppler echocardiography should not be adversarial, but complementary. Increasingly, noninvasive techniques will support or complement the invasive procedure, particularly as echo technologies for invasive applications are further developed.

Cardiac Catheterization↗
PubMed2003

Development and validation of a simple model to predict severe coronary artery disease after myocardial infarction: potential impact on cardiac catheterization use in the United States and Canada.

BACKGROUND: Improved patient selection may optimize the efficiency of cardiac catheterization in both high- and low-rate regions. The purpose of this study was to develop and validate a clinical model for predicting high-risk coronary artery disease (CAD) after myocardial infarction (MI) and to examine the model's potential impact on the use rate of both US and Canadian catheterization practices. METHODS AND RESULTS: By the use of baseline clinical variables from 1122 patients in the angiographic substudy of the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes (GUSTO-1) trial, we developed a model that was predictive of severe CAD (left main or triple-vessel disease). The final model, which included prior MI, age, sex, hyperlipidemia, and decreased left ventricular ejection fraction (C-index = 0.70), was externally validated in 781 patients in the GUSTO IIb trial. Although the probability of severe CAD predicted 5-year survival, the frequency of catheterization in both Canada and the United States bore no relationship to severe CAD risk in the GUSTO-1 trial. By use of the model, we estimated that as much as 15% of US catheterizations from both GUSTO-1 and GUSTO IIb might have been avoided, without significantly compromising the number of patients with severe CAD who were identified (sensitivity = 0.94). By applying the model to Canadian practices, an additional 30 cases of severe CAD might have been identified per every 1000 catheterizations performed, without increasing the catheterization rate. CONCLUSIONS: The likelihood of severe CAD after ST-elevation MI may be predicted from simple baseline clinical variables. The use of a severe CAD predictive model to guide patient selection might enhance the cost-effectiveness of both aggressive and conservative catheterization practices.

Analysis of Variance↗
PubMed1997

Developing a cardiac catheterization education program.

This article describes the establishment of a coordinated education program for patients having a cardiac catheterization. The article focuses on developing the program content, instructional aids, and the education of the staff doing the actual patient education for this group of patients and their families.

Cardiac Catheterization↗
PubMed1996

Serum lidocaine concentrations after subcutaneous administration in patients undergoing cardiac catheterization in a pediatric institution.

OBJECTIVE: We wished to determine serum lidocaine concentrations after subcutaneous injection during cardiac catheterization. METHOD: Serum lidocaine concentrations were measured in 50 patients during catheterization. RESULTS: Serum concentration was linearly related to dose per kilogram of body weight. Lidocaine concentrations were therapeutic in 38% of patients. CONCLUSION: Lidocaine dose must be considered when the drug is used for local anesthesia in children.

Anesthetics, Local↗
PubMed2003

Cardiac catheterization in children as outpatients: potential, eligibility, safety and costs.

BACKGROUND: Outcomes and costs of inpatient versus outpatient pediatric cardiac catheterization have not been extensively evaluated. METHODS: For a cost-consequence analysis, we reviewed the medical records and cost data in a Swiss pediatric hospital. We compared outcomes and costs of observed inpatient management versus hypothetical planned same-day discharge for patients meeting the outpatient catheterization criterions for an American pediatric hospital. RESULTS: Among 346 catheterization admissions occurring from January, 1998 through December, 1999, 179 met the American criterions for outpatient catheterization. Complications observed, and/or nursing interventions begun within 5 hours of catheterization, might have required overnight observation in 41 of the 179 admissions (22.9%). The remaining 138 patients were stable at five hours, and presumably could have been discharged the day of the procedure. Routine pre-discharge imaging detected significant complications following three interventional procedures. Postulated costs from the perspective of the provider, counting hospital and physician expenditure were calculated for the Swiss franc in 2000 at a rate of 1.69 francs for each American dollar, averaged 10,946 francs per inpatient, versus 9790 francs for outpatient treatment (p < 0.001 by paired t-test). Estimated revenue deficits, calculated as costs minus reimbursement, averaged 8565 francs per inpatient versus 1756 francs per patient treated as an outpatient. CONCLUSIONS: Half the patients being catheterized in the Swiss hospital met the external criterions for attempted outpatient catheterization. Most might have been safely discharged on the same day, with modest savings in costs, and reduced deficits in terms of revenue. Routine predischarge imaging may be more important than overnight observation. Outpatient catheterization merits prospective evaluation in Switzerland.

Ambulatory Care↗
PubMed1995

Predisposing risk factors and natural history of acute neurologic complications of left-sided cardiac catheterization.

The reported incidence of acute neurologic complications of left heart catheterization varies from 0.03% to 0.3%. The predisposing risk factors, clinical features, and natural history have not been well characterized. We retrospectively reviewed all cases of acute neurologic complications developing during or within 36 hours of diagnostic catheterization or angioplasty to determine the incidence, clinical features, and natural history, and (using a case-control methodology) the clinical variables associated with their development. During the 37-month study, 6,465 patients underwent diagnostic left-sided cardiac catheterization and balloon angioplasty or valvuloplasty, and 27 patients developed an acute neurologic complication (0.4%). The most common symptoms were visual disturbances (26%), hemiparesis (26%), and facial droop (26%). Deficits were localizable to the anterior or posterior circulation in 22 patients: posterior in 8 (36%), and anterior in 14 (64%). Long-term follow-up was available in all patients, with 17 of 27 (63%) having complete resolution with no residuum. With use of a case-control methodology and multiple logistic regression analysis, female gender, the presence of left ventricular hypertrophy, depressed ejection fraction, and the presence of > or = 2 coronary arteries with > 50% narrowing were independent predictors of a neurologic event.

Acute Disease↗
PubMed2005

Phantom aortic valve pressure gradient: discrepancies between cardiac catheterization and Doppler echocardiography.

We present a case of a patient scheduled for mitral valve replacement and possible aortic valve replacement. On Doppler examination, her peak transaortic pressure gradient measured on three separate occasions (pre-, intra-, and postoperatively) was approximately 60 mm Hg. In contrast, the peak-to-peak pressure gradient (cardiac catheterization) was 11 mm Hg. This latter gradient was confirmed in the operating room by direct simultaneous measurement of the pressures in the left ventricle and ascending aorta. Potential causes for this discrepancy are discussed, among which the "pressure recovery phenomenon" is considered the most important.

Aged↗
PubMed1965

Recommended criteria for cardiac catheterization in patients with aortic valve disease.

Criteria for selection of patients with aortic valve disease for cardiac catheterization are described, based on a study of 81 cases. Children with aortic stenosis warrant catheterization at the time when the clinical diagnosis is made, but in adults this examination may be deferred until symptoms appear or left ventricular hypertrophy is recognized. In patients with pure aortic insufficiency catheterization may be deferred until symptoms appear. When severe stenosis and insufficiency co-exist, the valve is usually heavily calcified. Thirty-seven per cent of patients with aortic valve disease have co-existing mitral lesions and these patients are usually women, are fibrillating and, as a rule, have atrial enlargement in contrast to those with aortic valve disease only. On rare occasions, patients with mitral valve disease have clinically silent but angiographically demonstrable aortic insufficiency; therefore, aortography should precede open-heart correction of a mitral lesion so as to detect minor degrees of aortic insufficiency.

Adolescent↗