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At least 1,063 records · Page 59Linked to original sources
PubMed2004

Diagnostic cardiac catheterization and revascularization rates for coronary heart disease.

BACKGROUND: Despite evidence of regional variation across North America, there have been no comprehensive studies of cardiac procedure rates for coronary heart disease in Canada. OBJECTIVES: To use available administrative data and a survey of catheterization facilities to examine regional and demographic variations in cardiovascular procedure rates. METHODS: A survey of all cardiac catheterization facilities in Canada was conducted, and the procedure counts from these facilities were used to determine provincial catheterization rates from 1997/1998 to 2001/2002. Procedure counts for 1997/1998 to 1999/2000 for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) were provided by the Canadian Institute for Health Information and used to calculate revascularization procedure rates. Population projections provided by Statistics Canada were used as denominators for calculating the rates, and direct standardization was used to obtain age- and sex-adjusted rates. RESULTS AND CONCLUSIONS: The crude rate of cardiac catheterization in Canada increased from 359.9 to 471.5 per 100,000 population across the five years studied. There was considerable variation in revascularization procedure rates across health regions and provinces. Between 1997/1998 and 1999/2000, there was little increase in the rate of CABGs performed in Canada but a marked increase in the rate of PCIs. For both CABG and PCI, rates were higher for men than women, and highest in the 65- to 74-year-old age category. This study provides a valuable 'snapshot' of cardiac procedure use rates but indicates a clear need for more comprehensive collection of cardiac care data in Canada.

Adult↗
PubMedDate not supplied

Echographic method for the estimation of cardiac output from mitral-valve area, heart rate, and diastolic-filling period in conditions of mitral stenosis: correlation with cardiac catheterization.

An orifice equation for the non-invasive measurement of mitral-valve area is demonstrated. It is shown that by combining this expression with the assumption of mitral-valve area invariance an orifice equation for the non-invasive assessment of cardiac output in conditions of mitral stenosis using simple echographically measureable variables can be developed. This equation is V = (21)-1 R X A X T2, where V = cardiac output in ml, R = heart frequency, A = mitral-valve area in cm2 and T = diastolic-filling period in sec X min-1. These results suggest that when mitral-valve area is accurately measured at one point in time, cardiac output may be measured at subsequent times at a clinically useful level from a knowledge of the echographically measurable variables of heart rate and diastolic-filling period.

Cardiac Catheterization↗
PubMed2005

Percussion pacing in a three-year-old girl with complete heart block during cardiac catheterization.

Complete heart block frequently requires emergency pacing to restore systemic perfusion. We report the case of a 3-yr-old girl undergoing interventional atrial septal defect closure who suffered from transient complete heart block with circulatory arrest. Transthoracic mechanical pacing for more than 3 min provided temporary support, sustaining an adequate cardiac output until sinus rhythm resumed.

Cardiac Catheterization↗
PubMed1985

Two-dimensional echocardiographic method for the estimation of cardiac output independent of left ventricular geometry. Comparison with cardiac catheterization in mitral stenosis.

An hydraulic formula for the estimation of cardiac output independent of the geometric status of the left ventricle was studied by comparing the predictions based upon echographic and catheterization data with the results of the standard Fick principle method for cardiac output. The formula tested specifies cardiac output as Q = (1/21) RAT2, where Q is the cardiac output in ml, R is the heart rate, A is the mitral valve area in cm2 and T is the diastolic filling period in seconds per minute. Cardiac output estimated by this equation corresponds with cardiac output as determined by the Fick principle method at a level characterized by a correlation coefficient of r = 0.92 and a standard error of SE = 0.15 L/min for N = 26. The results suggest that the new expression may be useful for estimating cardiac output from echographic data.

Cardiac Catheterization↗
PubMedDate not supplied

The choice of contrast agents in the cardiac catheterization laboratory.

The availability of newer and more expensive low osmolar contrast agents for cardiac angiography has forced a comparison with the standard ionic contrast agents. The milder hemodynamic effects of low osmolar agents make them the contrast of choice for the sickest patients; however, the existence of a reduction in the rate of anaphylactoid reactions or death during catheterization seems more doubtful. Guidelines for the selective use of the agents in the cardiac catheterization laboratory are offered, based on one hospital's experience of more than 20,000 procedures.

Anaphylaxis↗
PubMed2001

Validation of three myocardial jeopardy scores in a population-based cardiac catheterization cohort.

BACKGROUND: The Jeopardy Score from Duke University and the Myocardial Jeopardy Index from the Bypass Angioplasty Revascularization Investigation (BARI) have been validated but never applied to a large unselected cohort. We assessed the prognostic value of these existing jeopardy scores, along with that of a new Lesion Score developed for the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH), a clinical data collection initiative capturing all patients undergoing cardiac catheterization in the province of Alberta. METHODS: The predictive value of these three scores were compared in a cohort of >20,000 patients (9922 treated medically, 6334 treated with percutaneous intervention, and 3811 treated with bypass surgery). Scores were considered individually in logistic regression models for their ability to predict outcome and then added to models containing sociodemographic data, comorbidities, ejection fraction, indication for procedure, and descriptors of coronary anatomy. RESULTS: All scores were found to be predictive of 1-year mortality, especially when patients are treated medically or with percutaneous intervention. In these patients, the APPROACH Lesion Score performed slightly better than the other jeopardy scores. The Duke Jeopardy Score was most predictive in those patients undergoing coronary bypass surgery. CONCLUSIONS: Myocardial jeopardy scores provide independent prognostic information for patients with ischemic heart disease, especially if those patients are treated medically or with percutaneous intervention. These scores represent potentially valuable tools in cardiovascular outcome studies. The APPROACH Lesion Score may perform slightly better than previously developed jeopardy scores.

Adult↗
PubMed1970

Acute massive pulmonary embolism. Clinical and haemodynamic findings in 23 patients studied by cardiac catheterization and pulmonary arteriography.

Twenty-three patients are reported in whom a diagnosis of acute massive pulmonary embolism was confirmed by pulmonary arteriography. All patients had a history of less than 48 hours' duration and only two had previous cardiorespiratory disease. In such patients the haemodynamic abnormalities determined at catheterization are due to pulmonary embolism as an isolated disturbance. These abnormalities include an only moderate degree of pulmonary hypertension (PA systolic pressure 38.4+/-6.8 mm. Hg), right ventricular ;failure' (RVED 11.5+/-4.9 mm. Hg), arterial oxygen desaturation (86.4+/-11.2%) and a wide arteriovenous oxygen difference (8.1+/-1.8 ml./100 ml.), and low cardiac output. These haemodynamic abnormalities find their expression in the presentation and the clinical, electrocardiographic, and radiological findings which are described.

Acute Disease↗
PubMed1992

Markedly increased periprocedure mortality of cardiac catheterization in patients with severe narrowing of the left main coronary artery.

In early reports, coronary arteriography in patients with left main (LM) coronary artery disease (CAD) had a substantial risk, but recent reports suggest that arteriography in these subjects is now associated with a low mortality. The present study was performed to examine the periprocedure mortality in patients with LMCAD undergoing catheterization, to compare the periprocedure mortality in these patients with that in subjects with less CAD and to identify the variables associated with pericatheterization mortality in this patient cohort. Of 4,009 patients undergoing elective coronary arteriography from 1978 to 1992, 176 had LMCAD. Of the 10 deaths during or within 24 hours of catheterization, 5 occurred in these 176 subjects. This periprocedure mortality of 2.8% in patients with LMCAD was > 20 times that of those without LMCAD (0.13%). In comparison with the 171 patients with LMCAD who survived, the 5 who died were older (67 +/- 8 vs 58 +/- 12 years), and had more severe LMCAD (92 +/- 10% vs 72 +/- 16%) and a lower cardiac index (1.9 +/- 0.4 vs 2.6 +/- 0.7 liters/min/m2) (p < 0.05 for all 3 variables). Thus, even in the 1980s and early 1990s, patients with LMCAD have a high pericatheterization mortality, especially those who are older and have severe LMCAD.

Age Factors↗
PubMed1983

Causes of cine image quality deterioration in cardiac catheterization laboratories.

Deterioration of cineangiographic image quality can result from malfunctions or technical errors at a number of points along the cine imaging chain: generator and automatic brightness control, x-ray tube, x-ray beam geometry, image intensifier, optics, cine camera, cine film, film processing, and cine projector. Such malfunctions or errors can result in loss of image contrast, loss of spatial resolution, improper control of film optical density (brightness), or some combination thereof. While the electronic and photographic technology involved is complex, physicians who perform cardiac catheterization should be conversant with the problems and what can be done to solve them. Catheterization laboratory personnel have control over a number of factors that directly affect image quality, including radiation dose rate per cine frame, kilovoltage or pulse width (depending on type of automatic brightness control), cine run time, selection of small or large focal spot, proper object-intensifier distance and beam collimation, aperture of the cine camera lens, selection of cine film, processing temperature, processing immersion time, and selection of developer.

Cineangiography↗