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At least 703 records · Page 39Linked to original sources
PubMed2004

Calibration of Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures.

Kodak EDR2 film has been calibrated across the range of exposure conditions encountered in our cardiac catheterization laboratory. Its dose-response function has been successfully modelled, up to the saturation point of 1 Gy. The most important factor affecting film sensitivity is the use of beam filtration. Spectral filtration and kVp together account for a variation in dose per optical density of -10% to +25%, at 160 mGy. The use of a dynamic wedge filter may cause doses to be underestimated by up to 6%. The film is relatively insensitive to variations in batch, field size, exposure rate, time to processing and day-to-day fluctuations in processor performance. Overall uncertainty in the calibration is estimated to be -20% to +40%, at 160 mGy. However, the uncertainty increases at higher doses, as the curve saturates. Artefacts were seen on a number of films, due to faults in the light-proofing of the film packets.

Body Burden↗
PubMedDate not supplied

Venous thrombosis after cardiac catheterization in infants.

Factors influencing the rate of post-catheterization venous thrombosis were studied in 180 infants below one year of age. The initial cardiac catheterization was performed either with cutdown technique or percutaneously. At repeat catheterization on the ipsilateral side presence or absence of thrombosis was noted. The overall thrombosis frequency was higher than previously reported, 15.6 per cent. The rate increased with decreasing weight. An increased rate of thrombosis was also found with indwelling femoral vein catheter left in place for more than 24 hours, and infection. In 6 cases, thrombosis involved only the catheterized side and would have been missed by recatheterization from the contralateral side. It was noteworthy that 9 of the thromboses spared the catheterized vessel and engaged only the vena cava. Among factors not influencing thrombosis rate were age, type of cardiac malformation, cyanosis, early operation, catheterization time or balloon septostomy. Percutaneous or cutdown technique did not influence thrombosis rate.

Body Weight↗
PubMedDate not supplied

Acute pulmonary embolism in a neonate: precipitation during cardiac catheterization and successful treatment.

This report illustrates the rare occurrence of a pulmonary embolus in a neonate during cardiac catheterization. The patient was a term newborn who underwent repair of obstructed infradiaphragmatic total anomalous pulmonary venous connection. Postoperative risk factors for pulmonary embolism included severe pulmonary hypertension unresponsive to nitric oxide therapy, an indwelling venous catheter, and young age. Successful management was achieved by initial mechanical fragmentation with streptokinase infusion and monitoring by serial lung perfusion scans.

Acute Disease↗
PubMed1990

Surgical treatment of brachial artery injuries after cardiac catheterization.

A consecutive series of 532 patients (1.5%) required local thrombectomy and arterial repair after 34,291 transbrachial cardiac catheterizations performed at the Cleveland Clinic from 1980 to 1988. A total of 514 patients (97%) were discharged from the hospital with normal radial pulses and/or normal ulnar pulses after a single surgical procedure. Fourteen others (3%) each required one additional procedure to regain a distal pulse, and four patients either underwent two reoperations, received thrombolytic therapy, and/or remained pulseless. Surgical delay of more than 1 day after catheterization was associated with a higher incidence of recurrent thrombosis (12% vs 2%, p = 0.025). In comparison to our previous experience with iatrogenic brachial injuries, the liberal use of segmental arterial resection and overnight heparin anticoagulation seem especially to reduce the risk for early failure in all patients, but improvement was particularly marked in women (25% vs 6%, p = 0.0004).

Brachial Artery↗
PubMed1987

The role of the personal computer in the cardiac catheterization laboratory: an integrated approach to information management.

A personal computer-based data management system for the cardiac catheterization laboratory is described. This is a cooperative effort on the part of the Dutch academic hospitals, through the Interuniversity Cardiology Institute, to put in place a more uniform structure for data collection and reporting in the context of cooperative studies. The major design criteria included the necessity that the system provide a clear and present benefit to the users in terms of their day-to-day work. This requires a practical data entry package together with a full reporting capability, including management tools for supervision of the catheterization laboratory in general. Ancillary activities include quantitative analysis of ventriculograms and an elementary statistics package with graphics. To facilitate supportability of the system, commercially available packages for data base management, text processing, and communications have been used to advantage. After a prototype test phase involving two centers, five other centers have been equipped with similar systems and used successfully in the majority.

Cardiac Catheterization↗
PubMed1981

Left atrial myxoma. Is cardiac catheterization essential?

Although uncommon in children, primary cardiac tumors, especially left atrial myxomas, can be cured with surgery. We present our experience with a 12-year old boy with a left atrial myxoma diagnosed by two-dimensional echocardiography who underwent successful surgical resection without prior catheterization. We recommend that all patients suspected of having cardiac tumors undergo echocardiographic evaluation. As this case illustrates, the essential information for surgical management of myxomas can be obtained from two-dimensional echocardiograms, which obviates cardiac catheterization.

Cardiac Catheterization↗
PubMed1992

[Analysis of data from a database of patients submitted to cardiac catheterization].

77 variables with data from clinical, non invasive and invasive findings in 591 adult patients submitted to cardiac catheterization and/or coronary arteriography from 1988 to 1991 were analyzed. 51% had coronary arteriography for suspected coronary artery disease: 15% had no or insignificant disease and 8% had main left disease. Among 92 patients with valvular heart disease, coronary angiography ruled out coronary disease in 80%. In this group, 3 vessel disease was found only in patients older than 62 years of age and main left disease was rare. The etiology of valve disease was rheumatic in 72%. Congenital heart disease was the indication for invasive study in 8% of patients, atrial septal defect being the most common entity.

Adult↗
PubMedDate not supplied

Acute hemodynamic effects of tocainide in patients undergoing cardiac catheterization.

To characterize the acute hemodynamic effects of tocainide hydrochloride, a new antiarrhythmic agent, 11 patients undergoing diagnostic cardiac catheterization were given intravenous infusions of the drug for 15 minutes at rates of 0.50 (six patients) or 0.75 (five patients) mg/kg/min. The hemodynamic status of these subjects was determined before, during, and for 15 minutes after treatment, and blood levels of tocainide were followed during and after treatment. Tocainide blood levels at the end of the infusions were 14.9 +/- 1.6 microgram/ml (S.E.) and 15 minutes later were 6.0 +/- 0.7 microgram/ml. In these subjects treatment was not associated with significant changes in Ao or PCW, but it was associated with a statistically significant but small decrease in LV dp/dt. At the same time, LVED was not significantly elevated. Treatment was also accompanied by small increases in PA diastolic and mean pressures, but RA and RV were unchanged. Significant changes were not seen in HR, CO, CI, SV, SVR, or PVR. Thus, the intravenous infusion of 0.50 and 0.75 mg/kg/min of tocainide for 15 minutes produced small but statistically significant depression of left ventricular function without producing changes in CO or clinical evidence of congestive heart failure.

Adult↗
PubMed2002

Comparison of contrast echocardiography versus cardiac catheterization for detection of pulmonary arteriovenous malformations.

Because clinical diagnosis of pulmonary arteriovenous malformations (AVMs) is difficult and cardiac catheterization invasive, contrast echo has been used to aid in the diagnosis. Correlation between contrast echo and catheterization data in these patients remains poorly defined. We examined the ability to detect pulmonary AVMs by contrast echocardiography, pulmonary angiography, and pulmonary vein saturations in patients who have undergone cavopulmonary (Glenn) shunts. Pulmonary vein saturations were obtained from catheterization reports. Blinded observers reviewed angiographic and contrast echo data retrospectively in 27 patients who had undergone a Glenn shunt and in 19 controls with biventricular hearts. Contrast echo was positive in 68 of 99 lungs (69%). Angiography showed AVMs in 65 of 98 lungs (66%). Pulmonary vein desaturation was found in 13 of 45 lungs sampled (29%). Only 10 of 38 lungs with positive contrast echo had pulmonary vein desaturation, but only 1 patient had pulmonary vein desaturation without positive contrast echo. The degree of desaturation did not correlate with severity of contrast echo return; 6 of 11 patients with 3+ contrast echo studies had normal pulmonary vein saturations. In a control group of patients with biventricular hearts, only 1 of 19 (5.3%) contrast echos was weakly positive. Contrast echo correlates poorly with angiography and pulmonary vein saturation for evaluation of AVMs. Contrast echo is extremely sensitive and often positive despite normal pulmonary vein saturation. Assessment of pulmonary vein desaturation in 100% oxygen may improve its sensitivity and correlation with contrast echo. Additional studies are needed to follow patients with mildly positive contrast echo studies to enable determination of their clinical relevance.

Arteriovenous Malformations↗
PubMed1986

Reducing distress in pediatric patients undergoing cardiac catheterization.

This project collected data on the use of auditory tapes to reduce acute distress in pediatric patients during cardiac catheterization. Observations by the medical staff as well as patients' subjective experience indicated that the tapes were a useful adjunct in helping young patients tolerate the distress of the medical procedure. Differences in benefits were noted depending on the age of the patients. The greatest benefits were seen in the less than 1-year-old and 7- to 12-year-old age groups.

Adolescent↗
PubMed2006

Coronary pathophysiology in the cardiac catheterization laboratory.

While Coronary angiography remains the standard for the diagnosis and treatment of coronary artery disease within the cardiac catheterization lab, many lesion subsets require further investigation to determine their overall significance in causing symptoms. Direct measurement coronary flow and subsequently the ability to measure coronary pressure changes at maximal hyperemia have been developed to provide physiologic data to the catheterization operator which reveal the significance of coronary artery lesions in question and guide treatment. These measures, coronary flow reserve (CFR) and fractional flow reserve (FFR) have been validated against non-invasive tests for myocardial ischemia. Furthermore, FFR has also been studied in its ability to guide percutaneous coronary interventions in single vessel disease, multi-vessel disease, ostial side-branch lesions, and left main lesions.

Blood Flow Velocity↗
PubMed2004

Is cardiology consultation required before cardiac catheterization?

Background: In many hospitals, internists have begun to directly refer patients for cardiac catheterization without a prior cardiology consultation. The purpose of this study is to compare the results of a policy of mandatory consultation prior to catheterization with one of optional consultation. Methods: One hundred seventy-five consecutive patients who underwent catheterization with a prior cardiology consultation (closed group) were compared to 175 patients who underwent the procedure without a prior mandatory consultation (open group). The primary outcomes were defined as whether significant coronary disease was found and what therapy the patient received. Results: There was no difference in the percentage of patients who were found to have coronary disease in each group (72% in the closed group and 77% in the open group, P=NS), and there was also no difference in the percentage of patients who received revascularization therapy (43% in the closed group and 44% in the open group, P=NS). Conclusions: Allowing internists to refer patients directly for catheterization resulted in equivalent results as compared to requiring cardiology consultation. This study supports the policy of allowing direct referral for catheterization, but further studies are needed to compare the outcomes of cardiac patients cared for by hospitalists without cardiology consultation.

Journal Article↗
PubMed2004

[Caregivers and patient's anxiety level during cardiac catheterization].

This exploratory and quantitative study aimed to identify the anxiety level of 40 caregivers and 40 patients before cardiac catheterization and to establish a correlation among them and with sociodemographic variables, by means of the Anxiety-State Scale (IDATE). It was concluded that most of the patients present low anxiety levels, while most caregivers demonstrate medium levels of anxiety. No statistical correlation was found between anxiety levels and sociodemographic variables in the correlation analysis. In a comparative analysis, we observed that male caregivers are more anxious than female ones. Nursing interventions during this period can be more efficient if they include actions to reduce anxiety among family members/caregivers.

Aged↗