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PubMed1978

Why does a child with a normal heart undergo cardiac catheterization?

Children who have no heart disease at cardiac catheterization have usually been referred because of signs or symptoms on the background of a basal flow murmur. The ECG and chest x-ray are sometimes spurious and may lead to catheterization. Advances in noninvasive testing are helping to screen this population. Only in rare instances should the risks involved with catheterization be taken in a child with a basal flow murmur and no other evidence of heart disease.

Adolescent↗
PubMed1978

Management of the upper extremity with absent pulses after cardiac catheterization.

Thirty-one patients had a delayed loss of brachial artery and radial artery pulse after cardiac catheterization; eleven of the patients had early embolectomy or a vein patch graft and 82% of these had immediate restoration of pulse and remained asymptomatic. Early surgery failed in two patients, requiring late vein bypass grafting for claudication. Twenty patients did not have early surgery, eleven (55%) remaining asymptomatic and nine (45%) developing ischemic symptoms. Five of these nine patients (25%) required late vein bypass grafting for severe claudication. Of the fifteen patients who lost their pulse and did not undergo surgery, the average Doppler forearm pressure immediately following the occlusion was 50 mm Hg (pressure index=0.46). The average Doppler pressure measured at the time of follow-up was 80 mm Hg (pressure index = 0.61). Early local surgery is highly successful in patients who lose their radial artery pulse after cardiac catheterization. Conservative nonoperative therapy may be successful but often results in late ischemic symptoms that may require late vein bypass grafting.

Arm↗
PubMed1992

Influence of arterial access sites and interventional procedures on vascular complications after cardiac catheterizations.

The purpose of this study is to define the incidence of complications at the arterial access site after cardiac catheterization. The influence of the arterial access site on these complications was identified, as were the clinical characteristics of these problems. A total of 8,797 cardiac catheterizations were performed over the 3-year period of this study. Diagnostic catheterizations and percutaneous transluminal coronary angioplasties (PTCAs) were included, and the arterial access site was identified. Diagnostic catheterizations were performed via the brachial artery (group I, n = 3,137) or the femoral artery (group II, n = 4,055). PTCAs were also performed via the brachial artery (group III, n = 32) or the femoral route (group IV, n = 1,573). Ninety-five major vascular complications occurred during the course of this study. The frequency of complications was higher with brachial artery catheterization when compared with the femoral route. PTCA was associated with a higher complication rate than diagnostic studies. Brachial artery complications were primarily arterial thromboses, which were easily diagnosed and treated. Femoral artery complications were more complicated, difficult to identify, and associated with significant morbidity.

Angioplasty, Balloon, Coronary↗
PubMed1976

Care of patients after cardiac catheterization.

In an effort to provide more definitive diagnosis for Air Force flyers referred to the USAF School of Aerospace Medicine, cardiac catherization has been performed, as indicated, on over 425 flyers since 1971. Since they are an apparently healthy and asymptomatic population, their recovery after cardiac catheterization is usually uneventful. However, the nurse must be able to recognize and interpret significant potential and/or existing post-catheterization complications. Nursing care of the patient after this procedure is essential to the successful completion of the test. Since any invasive procedure can lead to complications, quick and accurate nursing assessment and action are essential. The possible complications of cardiac catheterization which the nurse may encounter have been divided into possible causes, and a suggested plan of action. Reference tables are provided for each of the two main classifications, in an effort to provide quick guidance for the nurse responsible for care of the patients after catheterization.

Aerospace Medicine↗
PubMed1978

Physician and patient exposure during cardiac catheterization.

A survey of the literature was conducted to establish the anticipated ranges of exposure to both physicians and patients during cardiac catheterization. A brief explanation of a technic for using time-lapse photography and a computer model for exposure calculation is presented. The thermoluminescent dosimeter (TLD) results used as controls for exposure values calculated by the developed technique are presented in detail. Physician eye exposures of approximately 20 mR per cardiac catheterization procedure were measured, which would suggest a limit of five procedures per week for physicians. The average patient skin entrance exposure of 28 R is high, as is the 12 mR gonadal exposure; however, they are accepted because of the possible benefits of the procedure.

Cardiac Catheterization↗
PubMed1977

Neurologic complications of cardiac catheterization.

A retrospective survey was made of neurologic complications of cardiac catheterization. Of 10 patients, only one had a diffuse disorder, with seizures of a type associated with reaction to contrast agents. Disorders in the other nine patients appeared to be embolic in nature. Five of these nine involved deficits indicating damage in the vertebrobasilar territories, suggesting local trauma to vessels as a source of the embolic material.

Adolescent↗
PubMed1992

[Historic perspective of cardiac catheterization].

In 1929 Forssman introduced a catheter into one of his left forearm veins and advanced it up to the right atrium, opening the possibility of cardiac catheterization in man. Since 1940, right heart catheterization was systematically performed by Andre Cournard and Dickinson Williams and many other researchers who contributed in the following decade with different approaches; at the present time the retrograde access through the femoral or brachial artery is the most widely used. Angiocardiography evolved in different countries between 1929 and 1959. Selective coronary cineangiography, developed by Sones, has been one of the most important advances in this field. Cardiac catheterization has been a valuable tool in cardiovascular research and diagnosis. Moreover, it has contributed to the progress of cardiac surgery and critical care medicine. Lately, it has derived to therapeutic procedures such as coronary angioplasty and percutaneous, dilatation of stenotic heart valves and closure of some congenital shunts. "Interventional catheterization" has become one of the most frequent indications for this procedure as long as many heart diseases are correctly diagnosed by means of non invasive technique.

Angiocardiography↗
PubMed1975

Operative repair of atrial septal defect without cardiac catheterization.

Thirty-three children with secundum or sinus venosus atrial septal defects underwent operative correction at the University of Minnesota Hospitals between January, 1972, and December, 1973. Nineteen of these patients (58%) did not have cardiac catheterization as part of their preoperative evaluation, since clinical assessment of the child, with or without corroborative evidence obtained by echocardiography and radionuclide angiocardiography, provided sufficient information to permit recommendation of operation. In the majority of patients with uncomplicated atrial septal defect, cardiac catheterization is not a necessary part of the preoperative evaluation and may be reserved for those patients with unusual clinical or laboratory features.

Adolescent↗
PubMed1977

The effects of transfemoral cardiac catheterization on limb blood flow in children.

Blood flow was measured with a mercury-in-rubber strain-gauge plethysmograph in the utilized and intact extremity during and 24 hours after uncomplicated (with no clinical signs of vascular insufficiency) percutaneous right and left cardiac catheterization in 20 children. In this group, there was a significant decrease of the flow in the utilized extremity after entry into the artery, with the flow returning to normal within 24 hours after the procedure. Flow was markedly reduced in the utilized extremity of a child who developed thrombosis of the femoral artery after catheterization. Seven additional children were studied one to four years after retrograde catheterization. In this group the flows in utilized and intact extremities were equal at rest and with reactive hyperemia. It is concluded that uncomplicated transfemoral percutaneous cardiac catheterization in children does not impair the blood flow in the limbs.

Adolescent↗
PubMed1975

An off-line system for in-time analysis of cardiac catheterization data and for establishment of a cardiological database for retrospective studies.

The system described may be divided in two major parts: (i) automatic analysis of cardiac catheterization data running off-line on a Siemens 305 computer; (ii) storage and retrieval of the results from these analyses and additional data from related departments (thoracic surgery, internal medicine and clinical physiology) in a cardiological database on an IBM 370/155 computer. The first part is described with special regard to (i) operation and control during the phases of data collection, pre-processing, processing and storage of results; (ii) the presentation of the results in a complete and readable form and (iii) the modular design of the software. The results of an evaluation of the computer methods versus manual methods are also presented. The second part has been described with regard to the type of data entered in the cardiological database. The structure of the database and the programs used for storage and retrieval have not been described in detail in the present publication.

Analog-Digital Conversion↗
PubMed1978

[Cardiac catheterization of neonates and young infants using a flow-directed balloon catheter (author's transl)].

In cardiac catheterization with the Swan-Ganz-flow-directed balloon catheter the aorta or, in transposition of the great arteries, the pulmonary artery was entered from the left ventricle with a special heart catheterization technique in 68 neonates and young infants. In the same way selective aortography was performed in 29 of these patients. This catheterization technique has the following advantages: 1. the complete evaluation of complex cardiac anomalies even in neonates, 2. selective aortography avoiding the retrograde arterial catheterization, 3. reducing the risk of cardiac perforation or myocardial staining due to the contrast injection using the usual semirigid catheters. Balloon rupture or knotting are specific but avoidable complications.

Age Factors↗
PubMed1978

Chromosome damage in infants and children after cardiac catheterization and angiocardiography.

Current diagnostic cardiac studies in infants and children result in longer x-ray exposure times and in more angiocardiograms per patient. Blood samples removed before and immediately after such studies in 20 infants and children have shown chromosome damage in all. The damage was equal to an in vitro absorbed dose in the range of 20 to 50 rads. Since the effect was considerably greater than that calculated from the x-ray exposure dose to the patient, it is concluded that the damage is mainly due to the contrast agent used in angiocardiography. Long-term follow-up studies on such patients are indicated.

Adolescent↗
PubMed1976

On-line computer processing of pressure data from cardiac catheterizations.

A flexible program system for on-line analysis of pressure data from cardiac catheterizations is described. The programs are implemented on an IBM 1800 computer, equipped with remote oscilloscope/keyboard terminals. The current computer system can handle any combination of up to 4 pressure signals. During catheterization, measurement specifications (i.e. calibration levels or sites of pressure recordings) are entered via the keyboard immediately before each recording. As an option the whole expected measurement sequence may be stored on disk before the catheterization starts. This method will minimize the necessary interaction with the computer when the same catheterization procedure is used on several occasions. Changes from the predetermined scheme may, however, be undertaken before each recording to meet with unexpected events that may arise during the catheterization. After computer detection of calibration levels, the recorded signals are digitized during 20 seconds and analysed beat-by-beat. Calculated values are averaged and presented on the terminal oscilloscope in tabular and/or graphic form. The waveform analysis performed by the program system is validated in a statistical comparison between manually and automatically computed values.

Cardiac Catheterization↗
PubMed1975

Cardiac catheterization and selective angiography in infants with a new flow-directed catheter.

Preliminary experience with a new flow-directed pediatric angiography catheter in 35 infants indicates that catheterization of all cardiac chambers and both great vessels can be accomplished without risk of perforation or major arrhythmia. Antegrade access to the aorta from the left ventricle via the foramen ovale reduced the need for retrograde arterial catheterization. The maneuverability of this balloon-tipped catheter coupled with the ability to perform safely selective angiography at any site entered establishes a unique advantage over standard cardiac catheters now in use. The success with this catheter in performing right and left heart studies and the safety in its use promise to significantly reduce the risk of mechanical and angiographic accidents during the intracardiac investigation of critically ill infants with congenital heart disease.

Angiocardiography↗
PubMed1976

Pulmonary hypertension and foreign body granulomas in intravenous drug abusers. Documentation by cardiac catheterization and lung biopsy.

In this report we confirm the presence of pulmonary hypertension by cardiac catheterization in four intravenous drug abusers with biopsy-documented foreign body granulomas in the pulmonary vessels and interstitium. Each patient had a history of intravenous injections of alpha-sympathomimetic agents obtained from nasal inhalers. There agents may have contributed to the disease by constricting small vessels when simultaneously injected foreign bodies were passing through the vasculature of the lung. The severity of the pulmonary hypertension correlated well with the decrease in single breath diffusing capacity in each case. Pulmonary hypertension may contribute significantly to the increased morbidity and mortality observed in intravenous drug users.

Adult↗
PubMedDate not supplied

The relationship between spontaneous coping strategies and perceived anxiety of patients undergoing cardiac catheterization.

Little is known about how patients spontaneously cope with the inherent stressors of the cardiac catheterization procedure. In this study, spontaneous coping strategies were identified and the relationship between coping strategies and anxiety throughout the procedure was examined. Data consisted of 62 patients' subjective ratings of anxiety, reported at 6 points during the procedure, and the coping strategies which were used at those times. The Coping with Invasive Medical Procedures (CIMP) Scoring System was developed and utilized to examine the relationships between coping and anxiety. At various points throughout the procedure, "control" and "hoping" were associated with high anxiety, while "passive coping" and "positive reframing" were associated with low anxiety. Patients who repeatedly changed coping strategies during the procedure experienced slightly less anxiety than those using a more consistent coping approach. The results are discussed with an emphasis on patient teaching.

Adaptation, Psychological↗
PubMed1976

Vectorial characteristics of ventricular extrasystoles stimulated during cardiac catheterization.

Ventricular extrasystoles (VES) from different areas of the ventricular muscle mass were obtained by mechanical stimulation of inflow and outflow regions of the right ventricle (RV) and apical and basal portions of the left ventricle (LV) during cardiac catheterization. Cube system vectorcardiogram (VCG) patterns of VES from each location were analyzed to determine the specificity of vector orientation from each site. Transverse plane VCG distinguished between nonseptal LVES and RVES, while a combination of transverse and either sagittal or frontal planes permitted further localization of septal VES to inflow or outflow regions of the RV and apical and basal areas of the LV.

Adult↗