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 919 records · Page 51Linked to original sources
PubMed1989

Damage to physicians' gloves during "routine" cardiac catheterization: an underappreciated occurrence.

Recently, concern for the protection of health care employees and health care recipients has led to increasing awareness of transmitted infections. However, it is evident that damage of barrier methods of controlling infection can occur and go undetected. In a prospective study conducted from January 13, 1989 through February 15, 1989, 100 sequential pairs of gloves (200 gloves) worn during routine pediatric cardiac catheterizations were evaluated for punctures. A control group of 25 pairs of unused physicians' gloves was also evaluated for the presence of spontaneous leakage. In the 25 pairs of unused gloves (50 gloves), no punctures were detected, whereas in the 200 gloves worn during the catheterization procedures, punctures were found in 38 gloves or 19% (p less than 0.001). When comparing the frequency of punctures with respect to the digits, 81% of the punctures were detected within the thumb and index finger of the gloves. In the majority of instances, physicians describe stopcock manipulation as the cause of the punctures. Implication of the stopcock as a possible mechanism for glove damage can be isolated to the stop mechanism on the stopcock pivot. Although surgeons' gloves are worn in many procedures besides surgery, no previous studies have defined the incidence of glove punctures during these procedures. Recommendations include a redesign of the stopcock as a protective measure and immediate change of latex surgeons' gloves whenever damage is suspected.

Cardiac Catheterization↗
PubMed1992

Comparison of preload recruitable stroke work, end-systolic pressure-volume and dP/dtmax-end-diastolic volume relations as indexes of left ventricular contractile performance in patients undergoing routine cardiac catheterization.

The end-systolic pressure-volume relation, the relation between stroke work and end-diastolic volume, termed the preload recruitable stroke work relation, and the relation between the peak of the first derivative of left ventricular pressure (dP/dtmax) and end-diastolic volume have been employed as linear indexes of left ventricular contractile performance in laboratory animals. The purpose of this study was to examine the relative utility of these indexes during routine cardiac catheterization in seven human subjects (mean age 48 +/- 18 [SD] years) with a normal left ventriculogram and coronary angiogram. Left ventricular pressure was recorded continuously with a micromanometer catheter, and left ventricular volume was derived from digital subtraction contrast ventriculograms obtained at 30-ms intervals. Transient occlusion of the inferior vena cava with a balloon-tipped catheter was employed to obtain beat to beat reductions in left ventricular pressure and volume over 8.7 +/- 1.7 cardiac cycles. Stroke work declined by 49 +/- 13% during vena caval occlusion, but end-systolic pressure fell by only 26 +/- 11%, and changes in dP/dtmax were small and inconsistent (12 +/- 22%). Consequently, the range of data available for determination of the preload recruitable stroke work relation greatly exceeded that for the end-systolic pressure-volume relation and the dP/dtmax-end-diastolic volume relation, and much less linear extrapolation from the measured data was required to determine the volume-axis intercept. Preload recruitable stroke work relations were highly linear (r = 0.95 +/- 0.07), and much more so than end-systolic pressure-volume relations (r = 0.79 +/- 0.23).(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography, Digital Subtraction↗
PubMed2005

Measurement of total pulmonary arterial compliance using invasive pressure monitoring and MR flow quantification during MR-guided cardiac catheterization.

Pulmonary hypertensive disease is assessed by quantification of pulmonary vascular resistance. Pulmonary total arterial compliance is also an indicator of pulmonary hypertensive disease. However, because of difficulties in measuring compliance, it is rarely used. We describe a method of measuring pulmonary arterial compliance utilizing magnetic resonance (MR) flow data and invasive pressure measurements. Seventeen patients with suspected pulmonary hypertension or congenital heart disease requiring preoperative assessment underwent MR-guided cardiac catheterization. Invasive manometry was used to measure pulmonary arterial pressure, and phase-contrast MR was used to measure flow at baseline and at 20 ppm nitric oxide (NO). Total arterial compliance was calculated using the pulse pressure method (parameter optimization of the 2-element windkessel model) and the ratio of stroke volume to pulse pressure. There was good agreement between the two estimates of compliance (r = 0.98, P < 0.001). However, there was a systematic bias between the ratio of stroke volume to pulse pressure and the pulse pressure method (bias = 61%, upper level of agreement = 84%, lower level of agreement = 38%). In response to 20 ppm NO, there was a statistically significant fall in resistance, systolic pressure, and pulse pressure. In seven patients, total arterial compliance increased >10% in response to 20 ppm NO. As a population, the increase did not reach statistical significance. There was an inverse relation between compliance and resistance (r = 0.89, P < 0.001) and between compliance and mean pulmonary arterial pressure (r = 0.72, P < 0.001). We have demonstrated the feasibility of quantifying total arterial compliance using an MR method.

Adolescent↗
PubMed1996

TAT, F1 + 2, and D-dimer levels in patients after coronary angiography with nonionic or ionic contrast media or after cardiac catheterization.

The prothrombotic effects of nonionic contrast media (NICM) have been evaluated in both biological and clinical studies. The question of whether there is a higher risk of thromboembolism during angiography with NICM than with ionic contrast media (ICM) has not yet been answered, nor has the precise role of the angiographic procedure per se in such complications been determined. The present study was performed to compare in vivo the potential prothrombotic effects during cardiac angiography of an NICM with those of an ICM, to estimate the effects of the procedure per se, and to assess how long these effects might be maintained. We measured blood levels of three markers of activation of blood coagulation: thrombin-antithrombin III (TAT) complexes, prothrombin fragment 1 + 2 (F1 + 2), and the split product of fibrin, D-dimer, before and after coronary angiography in three groups of patients. In group 1, 14 patients underwent coronary angiography with the NICM iopamidol 370. In group 2, 10 patients underwent coronary angiography with the ICM ioxaglate. In group 3, 10 patients were evaluated immediately after cardiac catheterization, before the injection of contrast material, as controls. No statistically significant differences between the three groups were found in TAT, F1 + 2, or D-dimer levels at different times before and after coronary angiography. There was a trend toward a transient increase in TAT levels after coronary angiography with iopamidol, which at first suggested a possible brief activation of hemostasis with this NICM, but a similar trend was also seen in the control group. We hypothesize that not only the type of contrast material, but also the angiographic procedure per se and patient-related factors all play roles in determining a prothrombotic state during coronary angiography.

Aged↗
PubMed1997

Use of a collagen plug versus manual compression for sealing arterial puncture site after cardiac catheterization.

The aim of the study was to investigate (1) the safety and efficacy of the application of a collagen plug (Vasoseal) at arterial puncture sites, (2) the hemostasis time, and (3) the comfort for the patient of a collagen plug (Vasoseal) when compared with manual compression. Sixty-two patients were randomized either for application of a collagen plug (Vasoseal, group A, n = 33) or manual compression (group B, n = 29) after cardiac catheterization. All patients were evaluated for subjective pain score ranging from 1 to 5 (1 = no pain up to 5 = very strong pain). In addition the authors measured the time until hemostasis could be achieved. The patients were evaluated by duplex sonography for complications at days 1 and 7 after the procedure. The pain score demonstrated a significantly lower score in group A when compared with group B (P = 0.01). The mean time for hemostasis was significantly lower in group A (mean 9.6 minutes) when compared with group B (mean 23.6 minutes) (P = 0.0001). Regarding the complication rate there was no significant difference between the groups (group A vs group B, P = 0.82). The authors conclude that the application of a collagen plug at the arterial puncture site is a safe and time-saving method. In addition it is less painful and therefore better tolerated than manual compression.

Aged↗
PubMed1994

Does the use of new intracoronary interventional devices prolong radiation exposure in the cardiac catheterization laboratory?

OBJECTIVES: The aim of this study was to compare the duration of radiation exposure associated with new percutaneous coronary interventional devices with that associated with conventional balloon angioplasty. BACKGROUND: Radiation exposure levels have been documented to be higher with coronary balloon angioplasty than with routine diagnostic coronary angiography. However, the effect of new interventional devices on radiation exposure has not been studied. METHODS: Fluoroscopic and cineangiographic data from the Mayo Clinic cardiac catheterization laboratory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional coronary atherectomy (42 with adjunctive balloon angioplasty), 76 excimer laser angioplasty (50 with adjunctive balloon angioplasty) and 37 placement of an intracoronary stent (16 emergencies). RESULTS: Duration of fluoroscopy during balloon angioplasty was 24 +/- 18 min, which was longer than with directional atherectomy (18 +/- 8 min; p = 0.001). Fluoroscopy time was 25 +/- 17 min with laser angioplasty and 29 +/- 15 min with elective stent placement (neither time was significantly different from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if emergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angioplasty alone. CONCLUSIONS: Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergency stent placement is required.

Aged↗
PubMed1986

Quantitation of shunting at the atrial level using rapid acquisition computed tomography with comparison with cardiac catheterization.

Contrast-enhanced rapid acquisition computed tomography was employed to quantitate intracardiac shunts in two adult patients. Contrast medium was injected through a median antecubital vein and data were accumulated using the R wave-triggered flow mode. Time-density curves from a region of interest were generated by a gamma variate fit method and areas under the curves were calculated. Comparisons of calculated left to right shunts (Cases 1 and 2) with results of computed tomography and right to left shunt (Case 2) with cardiac catheterization data resulted in close agreement. This is the first report of quantitation of intracardiac shunts at the atrial level in humans by rapid acquisition computed tomography.

Adult↗
PubMed1996

Study of radiation doses to personnel in a cardiac catheterization laboratory.

Radiation safety guidelines and federal regulations (10 CFR Part 20) require that radiation workers who are likely to receive above a certain percentage of the effective dose equivalent limit be monitored and that exposure be maintained as low as reasonably achievable (ALARA). With few exceptions in our hospital, the badges that exceed the Level 1 ALARA limits were worn by personnel in the Cardiology Division. The objective of this study was to determine the reasons for the high personnel dosimeter readings for staff in the cardiac catheterization laboratory and implement corrective measures to keep exposures ALARA. The physicians were double badged. The fluoroscopic time for each patient examination performed by each physician in the catheterization laboratory was tabulated and compared with the exposure on the dosimeters of the person performing the study. Education and retraining of cardiology staff concerning radiation protection and the use of state-of-the-art equipment are major considerations in reducing worker radiation exposure.

Cardiac Catheterization↗
PubMed2001

Early ambulation after diagnostic cardiac catheterization: a 4 French study.

This study is intended to test whether the use of new 4 French (Fr) catheters can safely eliminate the need for supine bed rest and allow earlier ambulation while decreasing groin site complications and patient discomfort. Diagnostic left heart catheterization was performed using 4 Fr catheters via the femoral approach in 100 consecutive patients. After femoral sheath removal, the mean compression time with a mechanical compression device was 16.07 +/- 3.19 minutes. Mean manual compression time was 18.3 +/- 5.7 minutes. Ninety-eight patients were able to sit up 30 degrees immediately after hemostasis was achieved. The mean ambulation time was 2.18 +/- 0.71 hours. There were no major vascular complications. Four patients developed a small area (2.5-5 cm) of ecchymosis at the femoral arterial puncture site. The study demonstrated that upper body elevation and early ambulation are safe as soon as hemostasis is achieved after 4 Fr cardiac catheterization.

Adult↗
PubMed1984

Coronary flow reserve measured during cardiac catheterization.

The degree of arteriographically visualized narrowing in coronary arteries has been the most important criterion for evaluating coronary disease for more than 20 years. Increasing data, however, suggest that anatomy alone does not predict the physiologic consequence of individual stenoses. We have applied a new digital arteriographic method for measuring coronary flow reserve (CFR) in patients undergoing diagnostic, postbypass, and postangioplasty catheterizations. All vessels with high-grade stenoses (greater than or equal to 70%) were found to have lower CFRs than those of normal arteries (1.01 +/- 0.15 v 1.84 +/- 0.36). However, considerable CFR variability was found in vessels of lesser stenoses. Coronary arteries that had undergone successful bypass surgery or angioplasty had intermediate CFR levels (1.44 +/- 0.18 and 1.51 +/- 0.16, respectively). Our study suggests that CFR assessed during cardiac catheterization may be useful for evaluating intermediate coronary lesions and the efficacy of interventions.

Adult↗
PubMed2003

[Documentation in the cardiac catheterization laboratory using electronic databases--experiences in 176 German cath labs].

Due to the introduction of a variety of new features to the German health system, such as a new reimbursement system for inpatient work based on diagnosis-related groups, an obligation to detailed documentation for total quality management, as well as due to the continuing increase in the amount of imaging and other data within invasive cardiology, the use of electronic databases for documentation in the cardiac cath lab is of significant importance. The user friendliness and robustness of the software system for daily clinical practice is crucial for the acceptance of electronic documentation systems by physicians, nurses and technicians. This survey was aimed to explore the current practice and experiences of German cardiac catheterization labs with electronic databases particularly designed for documentation in invasive cardiology, including report generation of cath studies, risk and complication management and logistics for medical material ordering for the cath lab. Of the 176 hospitals and practices having agreed in taking part in this surveillance 165, are currently using an electronic database for administration of medical data and study reports. In 64% of the cath labs, a sub-specialized software system for detailed documentation of the course and the results of an invasive procedure, the human and material resources used, generation of the cath report, and documentation of procedural and post-procedural complications for total quality management is used. The acceptance and satisfaction with the software solutions currently available reveals to be rather inhomogeneous. While user-friendliness and flexibility of a number of software products were positively mentioned, main issues, such as missing hardware of software interfaces with the hospital information system for patient administration, missing stability of several systems, image management too complex and report configuration too inconvenient for daily clinical practice, were criticized. In general, in the light of continuing increase of the amount of clinical and imaging data as well as due to the legal obligation of detailed procedural documentation in all areas of invasive cardiology, a documentation system based on electronic databases bears the potential of an enormous economization of the daily workload of a cardiac cath lab. Prerequisites for the acceptance of such a system in clinical practice is not only the stability and reliability of the system but also the ability to link such a sub-system to existing databases via suitable interfaces and the flexibility of the system for modification of its features to meet the individual requirements of each user.

Adult↗