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Interventional cardiac catheterization.

Abstract

The use of the pediatric cardiac catheterization laboratory as a therapeutic modality has become standard practice in most pediatric cardiology centers. Accordingly, reviewing the results of this form of therapy has become very important. This review focuses on the initial and long-term results of balloon dilation procedures in infants and children. As the efficacy and safety has been proven for these early procedures, dilatation therapy has become available for the critically ill neonate with pulmonary and aortic stenosis. The usefulness of implantable devices for closing abnormal shunt pathways, such as the patent ductus arteriosus and atrial septal defect, has become clear. The importance of both transthoracic color-flow Doppler and transesophageal echocardiography in proper placement and follow-up of these implantable devices is now becoming apparent and also will be evaluated in this review.

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BibTeXRIS

W E Hellenbrand. 1991. Interventional cardiac catheterization.. https://doi.org/10.1097/00001573-199102000-00018

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Strain rate imaging for assessment of regional myocardial function: results from a clinical model of septal ablation.

BACKGROUND: Regional myocardial function assessment is essential in the management of coronary artery disease (CAD). Tissue Doppler imaging (TDI) by depicting local myocardial motion can potentially quantify regional myocardial function. Strain rate imaging (SRI) that depicts regional deformation is less susceptible to cardiac translation and tethering and may be superior to TDI for regional function analysis. We examined regional myocardial function using TDI and SRI in a unique clinical model of a small, discrete myocardial infarction. METHODS AND RESULTS: Ten patients with severely symptomatic septal hypertrophy underwent basal septal ablation via intracoronary alcohol injection and had TDI and SRI pre- and postablation. Invasive hemodynamics showed no appreciable change in global function. Peak systolic strain rate was significantly lower postablation versus preablation (-0.5 versus -1.2 s(-1), P<0.001) and when comparing infarct and noninfarct areas (-0.5 versus -1.5 s(-1), P<0.001). In contrast, peak systolic tissue velocities were similar pre- and postablation (3.9 versus 2.9 cm/s, P=0.16) and between infarct and noninfarct areas (2.9 versus 2.2 cm/s, P=0.13). SRI analysis demonstrated reduced systolic function in the peri-infarct zone and preserved systolic function in the remote nonischemic zone. CONCLUSION: In the clinical setting of a small, discrete infarct unaccompanied by changes in global function, SRI accurately depicted changes in regional function. These data suggest that SRI may be the optimal method for objective, quantitative assessment of regional myocardial dysfunction.

Cardiac Catheterization↗