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Diagnostic Cardiac Catheterization (diagnostic + cardiac_catheterization)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Re-access complication with a starclose device,

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 7 2009
Rekhi Varghese MD
Abstract Diagnostic cardiac catheterizations are predominantly performed using access through the femoral artery. To improve patient comfort and early mobilization, a number of percutaneous closure devices have been developed. One such device using the nitinol clip was developed by Abbott Vascular Devices and was approved for use on the basis of the results of the Clip Closure In Percutaneous Procedures (CLIP) study. The safety of repuncture through a previously deployed device has not been established in humans. We present the case of a patient who had an arterial line placed for post-operative monitoring after cardiac surgery at the site of a previous arteriotomy closed with the Starclose device. The catheter traversed through the central portion, tethered to the periphery of the ninitol clip, and required surgery for extraction. © 2009 Wiley-Liss, Inc. [source]

Cephalad origin of the superior vena cava and the level of the central venous catheter tip on chest radiographs

PEDIATRIC ANESTHESIA, Issue 1 2005
TOSHIMI ARAI MD
Summary Background :,There are suggested radiographic landmarks for the lower margin of the superior vena cava (SVC), but none for the cephalad origin of the SVC in children. Therefore, we determined the cephalad origin of the SVC in relation to the level of thoracic vertebrae in children. Methods :,Sixty-five patients (2,96 months) scheduled for routine diagnostic cardiac catheterization were the subjects of the study. Vena cavogram was obtained. The crossing point between the SVC and the innominate vein was considered as the cephalad origin of the SVC, then this point was related to the level of the thoracic vertebra as a radiographic landmark. Results :,In approximately 90% of the patients studied the proximal origin of the SVC was situated above the level of Th4/5 interspace. Conclusion :,We would like to suggest that the position of the tip of central venous line, when inserted via the right internal jugular vein, should optimally be at the level of Th4/5 interspace on the postoperative chest radiograph. [source]

Utilization of catheterization and revascularization procedures in patients with non-ST segment elevation acute coronary syndrome over the last decade

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005
Glenn N. Levine MD
Abstract The degree to which catheterization and revascularization procedures are utilized in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) during hospitalization has broad implications with respect to initial pharmacotherapeutic decisions (upfront therapies), treatment and hospital transfer protocols, guideline recommendations, and allocation of training, material, and financial resources. Analysis of data from multiple trials and registries of patients with NSTE-ACS has the potential to assess more broadly utilization of invasive and revascularization procedures and provide a wide angle or bird's-eye view of the management of such patients, complementing the data obtained from any one trial or registry. We therefore undertook a systematic overview of all large trials and registries of patients with NSTE-ACS conducted over the last decade that were deemed appropriate to provide information on catheterization and revascularization procedures. Although not unexpectedly the percentage of patients with NSTE-ACS managed with cardiac catheterization, percutaneous coronary intervention (PCI), and coronary artery bypass grafting varies in different clinical trials and registries, general findings and trends were still discernable from these studies. During the initial treatment period, the majority of patients were ultimately treated with medical therapy alone (e.g., without revascularization). The percentage of those NSTE-ACS patients undergoing diagnostic cardiac catheterization who were then managed with PCI increased over the last decade and now stands at approximately 50%. Of NSTE-ACS patients who undergo revascularization, the percentage of those patients who are revascularized via PCI similarly increased, and PCI is currently the revascularization procedure utilized in approximately three-fourths of patients undergoing revascularization. The percentages of patients undergoing invasive and revascularization procedures were consistently higher in the U.S. cohorts of study subjects when compared to non-U.S. cohorts of study subjects. © 2005 Wiley-Liss, Inc. [source]

Trained and supervised physician assistants can safely perform diagnostic cardiac catheterization with coronary angiography

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2003
Richard A. Krasuski MD
Abstract Using a prospectively collected database of patients undergoing cardiac catheterization, we sought to compare the outcomes of procedures performed by supervised physician assistants (PAs) with those performed by supervised cardiology fellows-in-training. Outcome measures included procedural length, fluoroscopy use, volume of contrast media, and complications including myocardial infarction, stroke, arrhythmia requiring defibrillation or pacemaker placement, pulmonary edema requiring intubation, and vascular complications. Class 3 and 4 congestive heart failure was more common in patients who underwent procedures by fellows compared with those undergoing procedures by PAs (P = 0.001). PA cases tended to be slightly faster (P = 0.05) with less fluoroscopic time (P < 0.001). The incidence of major complications within 24 hr of the procedure was similar between the two groups (0.54% in PA cases and 0.58% in fellow cases). Under the supervision of experienced attending cardiologists, trained PAs can perform diagnostic cardiac catheterization, including coronary angiography, with complication rates similar to those of cardiology fellows-in-training. Cathet Cardiovasc Intervent 2003;59:157,160. © 2003 Wiley-Liss, Inc. [source]

Coronary artery ectasia,Is it time for a reappraisal?

CLINICAL CARDIOLOGY, Issue 5 2007
P. Ramappa M.D.
Abstract Coronary artery ectasia (CAE) is a well recognized clinical entity encountered during diagnostic cardiac catheterization. The etiopathogenesis of this condition is poorly understood. Due to the frequent presence of associated obstructive coronary artery disease it is considered to be a maladaptive process of atherosclerosis. Based on its association with aortic aneurysm, coronary ectasia is considered to be caused by genetic abnormalities. It is usually not a benign condition, as normal smooth laminar flow is disrupted with a potential of thrombus formation. The role of long-term anticoagulation in this condition has not been well established. It is speculated that with increasing use of newer, noninvasive modalities the incidence of ectasia may rise, therefore necessitating this review. Copyright © 2007 Wiley Periodicals, Inc. [source]