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At least 721 records · Page 40Linked to original sources
PubMed1993

[Measurement of the uprising peak rate of right ventricular pressure-A simultaneous Doppler echocardiographic and cardiac catheterization study].

To develop a new method for measuring the right ventricular systolic function noninvasively, Doppler echocardiography (DE) and cardiac catheterization (CC) were simultaneously performed in 31 patients with tricuspid regurgitation (TR). The regurgitant velocities were recorded by the continuous-wave Doppler technique and converted into the instantaneous pressure gradients and right ventricular pressures using a modified Bernoulli equation. The uprising peak rate of the right ventricular pressure (IP) at the time point of dp/dt max and the ratio of dp/dt max/IP were calculated from both the pressure curves and Doppler spectra. The result showed that there were high correlations of dp/dt max, IP and dp/dt max/IP measured by DE and CC (r = 0.87, 0.89 and 0.89, respectively). The conclusion is that DE provides a feasible and reliable approach to the noninvasive estimation of the right ventricular systolic function in patients with TR.

Adolescent↗
PubMed1984

Reducing distress in pediatric cardiac catheterization.

To examine the efficacy of rehearsal in reducing distress in 3- to 6-year-old children undergoing diagnostic cardiac catheterization, 40 children were assigned randomly to the rehearsal preparation procedure or to usual preparation. The rehearsal program involved the use of behavioral rehearsal in the catheterization laboratory, manuals to explain the procedure to the parents, and coloring books to provide parents and children with a vicarious experience of catheterization. Rehearsed patients cried, yelled for mother, complained of pain less, and showed lower rates of motor activity than did control patients. Rehearsed patients also showed less overt regressive, aggressive, and anxiety behaviors at home following the catheterization than did controls. Parents in the rehearsed group showed less anxiety following the catheterization, and negative reactions in children correlated significantly with parental anxiety. Participants' reactions were uniformly more positive in the rehearsed than in the control patients.

Anxiety↗
PubMed1998

[Emergency stenting for acute left main coronary artery closure during cardiac catheterization].

We report a case of acute closure of the left main coronary artery, a rare complication of diagnostic cardiac catheterization, treated by emergency stenting prior to aorto-coronary bypass surgery. We suggest encroachment of the Judkins catheter into a calcified left main ostium; with dissection and acute thrombosis of this segment, as the possible mechanism. Clinically, the patient's condition deteriorated to cardiogenic shock and loss of consciousness. Remarkably, there was no angiographic evidence of significant left main coronary artery disease, besides the presence of calcification in the proximal part of the left coronary system and ventricularization of coronary pressure at the time of engagement. We chose to slide quickly the angioplasty guidewire through the left main coronary artery, which allowed prompt mechanical recanalization and rapid restoration of coronary flow, with dramatic clinical and hemodynamic improvement. This relatively simple procedure allowed stenting the left main artery after brief predilation, and the patient came to by-pass surgery in excellent condition. The rationale for surgery in this case was the need for complete coronary revascularization because of significant 3-vessel coronary artery disease.

Angioplasty, Balloon, Coronary↗
PubMed1980

Plasma creatine kinase isoenzyme determinations in infants and children. Characterization in normal patients and after cardiac catheterization and surgery.

In adults, plasma elevations of creatine kinase isoenzymes are highly specific for myocardial necrosis, however, the diagnostic sensitivity and specificity of MB CK in children have not been determined. Accordingly, we analyzed the CK isoenzyme activity in serial plasma samples from 147 patients, aged 2 days to 18 months. Forty-two patients underwent routine checkups and served as controls. Fifty-seven patients underwent cardiac catheterization for congenital heart disease, an additional 16 underwent non-cardiac surgery, and 32 cardiac surgery. Blood samples were obtained prior to surgery and catheterization and q6H x 3 thereafter. Total plasma CK and MB CK in normals averaged 62 +/- 22 (SD) and 1.7 +/- 0.8 IU/L respectively. Despite a fivefold increase in total plasma CK after catheterization and surgery, MB CK remained normal. After cardiac surgery, total CK increased from 68 +/- 18 to 905 +/- 231 IU/L, and MB CK increased from 1.7 +/- 0.6 to 13 +/- 7 IU/L. Thus, MB CK is specific for cardiac injury and would be a valuable adjunct in the diagnosis of myocarditis or in assessing interventions to minimize cardiac injury during surgery.

Cardiac Catheterization↗
PubMedDate not supplied

An evaluation of an acuity system as it applies to a cardiac catheterization laboratory.

Patient care using patient volume rather than acuity has been a long-standing problem in a cardiac catheterization laboratory in a central New Jersey Medical Center. The current pattern of staffing results in some of the nursing staff becoming unproductive from a patient care perspective. This recently has become a concern of the Vice President of Nursing who has the unpopular task of consolidating nursing positions. There is a very effective acuity measurement system, the Medicus Acuity System, in place for the various inpatient areas. This system also exists in the Emergency Department and is called EMERGE. The system collects and objectively weighs information regarding severity of patient needs or acuity. These data are collected daily and provide unit managers with information regarding hours of direct nursing care on their particular units. The information over time shows trends in direct care hours and allows these managers to target the average patient population. The system gives insight into units that require more and less nursing hours by hour of the day, day of the week, and month of the year. This makes overall housewide use of nursing personnel more patient-care appropriate and more financially sound, for example, in the summer months when acuity is shown to be higher. In today's managed care environment this author believes the practice of staffing units based on bed occupancy is now regarded as antiquated, inefficient, and impractical. This study investigated a modified version of the EMERGE tool and its ability to capture patient acuity as it relates to staffing in the cardiovascular laboratory (CVL). During the 5 days of data collection, 87 patients were cared for in the CVL. The modified EMERGE cards were completed on 54 of the 87 patients that week. This represented 62% of that total patient population. Each day data for 60% or more of the patients were entered into the study. The interrater reliability of the data collected was better than 98% each day with overall accuracy being 99.5%. This interrater reliability was based on the findings by the expert panel, who compared two or three (approximately 10%) of the actual nurses' notes to the matching EMERGE cards each day. More than 80% of the 54 patients were classified as Type 3, well above the Type 1 standard patient acuity category for the EMERGE system. Telemetry units with a majority of EMERGE Type 3 patients would require between 50 to 100 minutes of care per visit and would have a significant nursing workload. These units are where the CVL draws most of their patient population. In summary, this study reflects a growing trend in healthcare that requires justification of staffing through the productivity of workers. Acuity tools provide tangible and objective data about daily workload and productivity by measuring patient's needs. As managed care forces hospitals to cutt staff, acuity tools will become more important for evaluating productivity and retaining staff, especially nurses.

Cardiac Catheterization↗
PubMed1998

Anaesthesia care and the adult cardiac catheterization patient.

The number and types of procedures being performed in the adult cardiac catheterization suite have increased dramatically, with an aggressive move towards percutaneous interventional cardiac procedures. Here we review many of these procedures, including the current trends in North America and Europe. Coronary angioplasty is now more commonly performed than coronary artery bypass grafting. The past 5 years have seen a proliferation of coronary stenting procedures. Restenosis of coronary arteries continues to be a major area of research and concern.

Journal Article↗
PubMed1978

Cardiac catheterization by percutaneous femoral venous approach in infants weighing less than 5 kg: observations in 97 cases.

The technique of cardiac catheterization after percutaneous introduction of a catheter can now be accomplished in neonates thanks to the refinement of the equipment and to the physicians' experience. In 100 catheterizations performed in infants of less than 5 kg, the new technique was utilized 97 times. Thanks to the utilization of introducers it permits Rashkind atrioseptostomy. Its main advantage is the preservation of venous integrity and this allows repeat investigations through the same route.

Body Weight↗
PubMed1983

Progression of isolated aortic stenosis: analysis of 29 patients having more than 1 cardiac catheterization.

Factors related to progression of nonrheumatic aortic stenosis (AS) were analyzed in 29 adult patients who underwent serial hemodynamic studies over a mean of 71 months. AS was congenital in 8 patients and degenerative in 21. The patients were divided into 2 groups on the basis of the change in aortic valve area between the 2 studies. Twelve patients had a greater than or equal to 25% reduction in aortic valve area (Group I) and 17 patients had less than 25% decrease in aortic valve area (Group II). There were no significant differences between the 2 groups in age, interval between studies, cardiac output, left ventricular end-diastolic pressure, left ventricular peak systolic pressure and origin of AS (congenital or degenerative). Group I patients had significantly larger initial aortic valve areas than did Group II patients (1.3 +/- 0.9 cm2 versus 0.8 +/- 0.4 cm2, p = 0.02). Also, the initial peak transaortic pressure gradients were lower in Group I than in Group II (27 +/- 19 versus 58 +/- 38 mm Hg, p = 0.01). Group I patients had a significantly greater increase in pressure gradient and a greater reduction in cardiac output than did Group II patients (24 +/- 21 mm Hg in Group I versus -0.1 +/- 24.5 mm Hg in Group II, p = 0.01, and -1.0 +/- 1.3 liters/min in Group I versus 0.10 +/- 1.4 liters/min in Group II, p = 0.03). Thus, AS progressed in 41% of a selected group of patients who underwent repeated cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Clinical utility of rapid prescreening magnetic resonance angiography of peripheral vascular disease prior to cardiac catheterization.

PURPOSE: The presence of peripheral vascular disease, in particular iliofemoral disease, is responsible in part for vascular complications from femoral artery cannulation. We investigated whether prescreening for vascular obstructions with magnetic resonance angiography (MRA) in high-risk patients with peripheral vascular disease (PVD) would provide useful information to angiographers seeking to improve the safety and efficiency of femoral artery access at cardiac catheterization. METHODS: Twelve consecutive patients with known or suspected PVD underwent contrast-enhanced, aorto-iliofemoral MRA using a real-time BolusTrak technique. Contrast-to-noise ratios for each patient were calculated. The cardiac angiographer reviewed the MRA prior to catheterization and selected an access site. The patients' subsequent clinical course was evaluated, and a postprocedure questionnaire was completed by the angiographer to define the value of the prescreening MRA. RESULTS: No significant vascular complications occurred in these patients as defined by failure of initially chosen access site, arterial dissection, limb ischemia, pseudoaneurysm formation, hemorrhage (including retroperitoneal hematoma), or need for blood transfusion or emergency vascular surgical repair. Statistical frequency analysis of the responses in the postprocedure questionnaire demonstrated that the MR data were clinically valuable in (1) influencing the initial choice of access site; (2) influencing technical alterations to the standard access; and, (3) enhancing confidence in the selection of access site. CONCLUSIONS: MRA prescreening in patients with PVD is an effective, novel adjunct to cardiac catheterization in selected patients that improves physician confidence and influences technical choices during coronary angiography from the femoral artery approach.

Adult↗
PubMed1989

[Cost-effectiveness analysis of two-dimensional/Doppler echocardiography, cardiac catheterization and angiography in the diagnosis of congenital heart disease].

To compare the costs and effectivenesses of 2-dimensional/Doppler echocardiography (2D/DE), cardiac catheterization (CC) and angiography (CA) in the evaluation of cardiac anatomy in patients with congenital heart disease, these three kinds of examinations were performed in 100 patients before operation. The 100 patients had 120 separate cardiovascular abnormalities, of which 100 (83.3%) were prospectively identified by 2D/DE. The sensitivity and specificity of 2D/DE were: ASD, 87.9% and 100%; VSD, 97.9% and 96.1%; PDA, 86.7% and 98.2%, Tetralogy of Fallot, 6 of 6 patients; the overall sensitivity and specificity of the less common defects, 31.6% and 95.8%. Ninety-seven (80.8%) were prospectively identified by catheterization. The sensitivity and specificity of catheterization were: ASD, 87.9% and 100.0%; VSD, 80.9% and 94.6%; PDA 93.3% and 96.6%; Tetralogy of Fallot, 6 of 6 patients, the less common defects, 52.6% and 95.5%. Forty-five (81.8%) were prospectively identified by angiography in 55 patients. The sensitivity and specificity of angiography: ASD, 5 of 7 patients, VSD, 88.0% and 94.3%; PDA, 2 of 2 patients; Tetralogy of Fallot, 5 of 5 patients; the less common defects, 68.8% and 100.0%. The economic evaluations were performed. The costs of the depreciation (including equipments and houses), hospital bed, water and electricity, management and staffs' wage were: 2D/DE, RMB 46.09 per patient; catheterization, RMB 314.17 per patient; angiography, RMB 314.17. The ratios of cost to outcome (cost per correct diagnosis) of 2D/DE, CC and CA were: 55.33, 388.82 and 384.07 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2001

Stroke as a complication of cardiac catheterization: risk factors and clinical features.

The authors aimed to delineate the risk factors and radiologic pattern of stroke complicating cardiac catheterization. Twenty-two cases were matched with three control subjects. Stroke was significantly associated with severity of coronary artery disease and length of fluoroscopy time (OR 1.96 and 1.65). The use of MRI with diffusion weighting allowed the identification of multiple asymptomatic lesions and a subset of lacunar-type infarcts (23%), which most likely occurred on an atheroembolic basis.

Aged↗
PubMed1978

Measurement of atrial septal defect during cardiac catheterization. Experimental and clinical results.

The size of experimental and clinical secundum atrial septal defects may be accurately measured during cardiac catheterization. The position of the defects in the septum and their distance from the aortic and mitral valves may also be ascertained. A balloon catheter inflated with radiopaque dye is used for the measurement. The volume of dye in the balloon has been correlated with its maximal diameter. Thus, a no. 8-10 French catheter filled with 10 ml of diatrizoate (50 percent) has a diameter of approximately 25 mm and a no. 8-22 French catheter filled with 40 ml of diatrizoate a diameter of approximately 43 mm. Persistent arrhythmias or other adverse effects of the procedure were not observed. There was a high correlation between balloon-measured atrial septal defects and those measured at necropsy in the animals or at operation in the patients. These measurements aid in determining whether an ostium secundum defect is of proper size and location to be closed transvenously and may also prove valuable in physiologic studies of atrial septal defects or other cardiac anomalies.

Adolescent↗
PubMed1983

Cardiac catheterization after an acute myocardial infarction.

An important question facing the profession each and every day is whether to recommend cardiac catheterization to a patient who has just had an acute myocardial infarction. Criteria have been proposed and ongoing studies are helping to establish guidelines to determine which survivors of an uncomplicated myocardial infarction can benefit from a knowledge of the coronary anatomy and ventricular function. In the case presented in this vignette the problem is related to angina recurring during the early stages of an acute myocardial infarction. Postinfarction angina often reflects subtotal obstruction of a major coronary artery that supplies either a portion of the myocardium that had infarcted or myocardium distant from the zone of the infarction. This is a high-risk group. Here the criteria are firmly established. Coronary angiography should be performed promptly to help determine whether coronary artery bypass surgery or balloon angioplasty is indicated.

Cardiac Catheterization↗
PubMed1990

Alfentanil and fentanyl sedation in infants and small children during cardiac catheterization.

Thirty patients aged 1-23 mth received either alfentanil or fentanyl for the induction and maintenance of IV sedation during cardiac catheterization following oral flunitrazepam premedication (0.1 mg.kg-1). Patients breathed spontaneously 30 per cent oxygen in air. Both alfentanil and fentanyl abolished all reaction to pain and discomfort with minimal haemodynamic and respiratory changes. Induction doses of alfentanil and fentanyl were 20 +/- 6 and 2.5 +/- 1.1 (mean +/- SD) micrograms.kg-1, respectively, and maintenance requirements 30 +/- 12 and 1.5 +/- 0.6 micrograms.kg-1.h-1, respectively. These requirements were comparable among younger and older as well as cyanotic and acyanotic patients. The IV sedation described adds an effective method to the armamentarium of an anaesthetist working in the cardiac laboratory.

Alfentanil↗
PubMed2000

Midbrain ptosis caused by periaqueductal infarct following cardiac catheterization: early detection with diffusion-weighted imaging.

Isolated infarcts in the periaqueductal region are rare but have been reported after cardiac catheterization. The authors report a case of dorsal midbrain infarct which caused bilateral ptosis, partial upgaze paresis, and internuclear ophthalmoplegia imaged within eight hours with diffusion-weighted imaging (DWI). The lesion was later confirmed on T2-weighted images. Diffusion-weighted imaging can rapidly confirm the diagnosis of this rare brain-stem infarct.

Blepharoptosis↗
PubMed1987

Incidence of renal artery stenosis in a population having cardiac catheterization.

Patients with renovascular hypertension comprise only a small percentage of those with hypertension. In our study 102 consecutive patients who had cardiac catheterization were screened at the time of the procedure for renal artery stenosis. Only 65 (64%) of the 102 patients were hypertensive, and 14 of the total population (13.7%) had renal artery stenosis. Of these 14 patients, only five had more than 50% narrowing of the arterial lumen. By renal vein renin determination, only four of the five patients with significant renal artery stenosis had lateralizing renins. The frequency of significant renovascular hypertension does not justify the routine search for this problem during catheterization procedures, though it may be worthwhile if the patients are hypertensive. This area deserves further evaluation.

Adult↗