SEARCH · PubMed Health

Results for “Catheterization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources

PubMed1984

A new method to calculate aortic valve area without left heart catheterization.

Assessment of the severity of aortic stenosis remains a commonly encountered clinical problem. Noninvasive evaluation has to date not proven sufficiently accurate in most cases to permit clinical decision making in the individual patient. Therefore, cardiac catheterization and measurement of the valve area with use of the Gorlin equation remains the standard approach in patients with suspected aortic stenosis. Doppler ultrasound allows direct measurement of blood velocity in cardiac chambers. This technique was used to study 16 patients with suspected aortic stenosis after cardiac catheterization. Aortic valve area (AVA) was calculated with the equation AVA = CO/(SEP X mean velocity), where CO is cardiac output measured by thermodilution and SEP is the systolic ejection period derived from the Doppler tracings. The resulting value was compared with valve area calculated from cardiac catheterization data and an excellent correlation was noted (r = .99). This study demonstrates that Doppler ultrasound can be used to accurately measure aortic valve area without the need for left heart catheterization.

Aged↗

PubMed1985

Endogenous biosynthesis of prostacyclin during cardiac catheterization and angiography in man.

The potent platelet inhibitory and vasodilator properties of prostacyclin suggest that levels of this substance may be of relevance to drug action and pathologic processes in the coronary vascular bed. Attempts to estimate the coronary secretion rate of prostacyclin have relied on measurements of metabolites obtained via cardiac catheter, usually as an adjunct to coronary angiography. To test the hypothesis that such procedures might themselves perturb endogenous biosynthesis of prostacyclin we used mass spectrometry to measure plasma levels of 6-keto-prostaglandin (PG) F1 alpha across the coronary vascular bed, as well as to assess the excretion of a major urinary metabolite, 2,3-dinor-6-keto-PGF1 alpha (PGI-M), in patients undergoing cardiac catheterization. PGI-M excretion increased variably from a median 100 to 205 pg/mg creatinine (p less than .01) during catheterization with angiography and remained elevated 2 to 4 hr after initiation of the procedure. However, cardiac catheterization without angiography also stimulated metabolite excretion, perhaps reflecting catheter-induced vascular trauma. The direct effect of radiocontrast media on vascular release of prostacyclin was indicated by increased PGI-M excretion in healthy volunteers administered intravenous radiocontrast and by studies of the canine coronary artery and jugular vein in vitro. Measurement of plasma 6-keto-PGF1 alpha after left heart catheterization showed that levels in aortic (21 +/- 8 pg/ml) and coronary sinus (14 +/- 2 pg/ml) blood were increased compared with peripheral venous levels (less than or equal to 4 + 1 pg/ml) determined before this procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗

PubMed1989

Two-dimensional and Doppler-echocardiographic and cardiac catheterization correlates of survival in primary pulmonary hypertension.

To determine correlates of survival in primary pulmonary hypertension, we compared 41 echocardiography-Doppler and nine catheterization parameters with outcome in 26 patients. Mean follow-up was 19.7 months in survivors; mean survival was 4.8 months in 16 nonsurvivors. Cox life-table univariate analysis correlated two echocardiographic, three Doppler, and three catheterization variables with poor survival (p less than or equal to 0.05), and chi 2 analysis ensured the best critical values: severity of pericardial effusion, heart rate of more than 87 beats/min, pulmonic flow acceleration time of less than 62 msec, tricuspid early flow deceleration (T-DEC) equal to or less than -300 cm2/sec, mitral early flow-to-atrial flow velocity ratio (M-E/A) equal to or less than 1.0, catheterization cardiac index (CI) equal to or less than 2.3 l/min/m2, mean pulmonary artery pressure of more than 61 mm Hg, and diastolic pulmonary artery pressure of more than 43 mm Hg. Multivariate life-table analysis of noninvasive variables revealed the severity of pericardial effusion to be independently significant (p = 0.006), whereas analysis of catheterization variables revealed cardiac index to be independently significant (p = 0.014). Combined multivariate analysis did not differ from the noninvasive results alone. Categorical modeling of the eight significant variables split at their critical values (present or absent) revealed M-E/A, T-DEC, and CI to be independently significant by multivariate analysis (p = 0.0014). Analysis of the five echocardiography-Doppler variables alone revealed M-E/A, T-DEC, and heart rate to be independently significant (p = 0.0016). In both cases, mortality increased with the number of critical values reached.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed1990

Modification of human atrioventricular nodal function by selective atrioventricular nodal artery catheterization.

The hypothesis that human atrioventricular (AV) nodal function can be modulated selectively with a new technique of AV nodal artery catheterization was tested in eight subjects referred for diagnostic cardiac catheterization or electrophysiological studies. Three patients had no history of arrhythmias. Three patients had supraventricular tachycardia (SVT) due to reentry confined to the AV node (AVNRT). One patient had SVT due to reentry over a concealed AV bypass tract (AVRT-CBT), and one patient had nonsustained ventricular tachycardia. In each subject, sinus cycle length, AH interval, HV interval, AV nodal effective refractory period (AVN-ERP), and Wenckebach paced cycle length were measured in a control state. A flexible infusion catheter was then positioned selectively in the AV nodal artery of each subject. Through this catheter, a constant infusion of 0.1 mg/min procainamide at a flow rate of 0.125 ml/min (n = 1) or 50 micrograms/min acetylcholine at a flow rate of 0.25 ml/min (n = 4) was administered. Electrophysiological parameters were determined again during selective AV nodal artery drug infusion and during infusion of saline at identical rates. Two subjects developed transient AV nodal block during selective AV nodal catheterization alone and did not receive an infusion of drug or saline. A stable position of the AV nodal artery catheter could not be achieved in one other subject, who also received no drug or saline. In the other five subjects, drug infusion caused an increase in AVN-ERP from a control value of 312 +/- 52 msec to a value of 543 +/- 228 msec (p less than 0.05) and an increase in Wenckebach paced cycle length from a control value of 360 +/- 47 msec to a value of 572 +/- 217 msec (p less than 0.05). These parameters were unchanged from control during selective saline infusion. In two patients with AVNRT, drug infusion abolished SVT by causing complete blockade of ventriculoatrial conduction as well as lengthening of anterograde AVN-ERP. In the patient with AVRT-CBT, drug infusion abolished SVT by preventing repetitive anterograde AV conduction. Saline had no effect on SVT inducibility. Selective AV nodal artery catheterization enables AV nodal function to be modulated exclusively. Delivery of ablative agents to the AV node by this technique may be useful in patients with refractory SVT.

Acetylcholine↗

PubMed1992

The preponderance of posterior circulatory events is independent of the route of cardiac catheterization.

BACKGROUND AND PURPOSE: Central nervous system complications of cardiac catheterization are most often attributed to embolic events that occur at the time of catheter manipulation. Nevertheless, the reason that over 50% of these events are localized to the posterior circulation remains unexplained. One potential explanation offered for this preponderance is the use of the brachial artery approach. In this report, we examined the relation between the route of catheterization and central nervous system complications. SUMMARY OF REPORT: We retrospectively analyzed all central nervous system complications that occurred after cardiac catheterization through a femoral route at our institution over a 3 1/2-year period. Thirteen patients were identified as having central nervous system complications. Using defined criteria, posterior circulatory events still accounted for at least 54% of central nervous system complications. CONCLUSIONS: The preponderance of posterior circulatory events is apparently independent of the route of catheterization. Furthermore, given the array of neurological symptoms and their often complete resolution, we feel it is unlikely that embolism is the sole pathophysiological mechanism involved in these events.

Aged↗

PubMed1997

Local venous thrombosis after cardiac catheterization.

Pulmonary embolism is a rare but life-threatening complication of cardiac catheterization. Underlying deep venous thrombosis (DVT) is often not detectable clinically. To determine the true incidence of DVT the authors prospectively studied 450 consecutive patients (29% women, 71% men, mean age: fifty-eight years) undergoing a diagnostic cardiac catheterization. Patients were examined clinically and by duplex sonography with a high-resolution (5 or 7.5 MHz) transducer before and twenty-four hours after catheterization before mobilization. Duplex sonography excluded complete proximal DVT in all patients. Only partial occluding thrombi (pDVT) were detected in 11 (2.4%) patients. The thrombi were always localized at the puncture site. In 2 patients a difference was found in the circumferences of the legs, but no other clinical signs of DVT were seen. With use of continuous wave (cw) Doppler sonography, only 3 of these 11 patients (27%) showed a spontaneous (s) sound. Phlebography was performed in 4/11 patients (36%). In 2 patients the diagnosis was confirmed; in 1 patient extravenous compression was assumed, and the other demonstrated a normal-appearing phlebography at the time of investigation. Logistic regression analysis yielded a 3.5 times higher risk for developing a pDVT if a venous puncture was performed in addition to arterial puncture. Furthermore a 9.8 times higher risk was found if more than one venous puncture was necessary. During the follow-up no patient developed clinical signs of pulmonary embolism. The results of this study demonstrate that DVT is a rare complication of cardiac catheterization (0/450 patients), but pDVT occurred in 2.4%. Risk factors for pDVT are the venous puncture itself and multiple puncture attempts. Clinical relevance of pDVT remains to be determined.

Cardiac Catheterization↗

PubMed1977

Hydro- and hemodynamic effects of catheterization of vessels. III. Experiments with a rigid-walled model.

An experimental and a theoretical investigation has been performed on some essential factors influencing the volumetric flow rate through and the static pressure in a catheterized, rigid-walled vessel model. These factors comprise: (a) the length of the catheter introduced into the vessel, (b) the catheter diameter, (c) the vessel diameter, (d) the dynamic viscosity of the liquid and (e) the mode of catheterization. Theoretical expressions for pressure and volumetric flow rates have been observed for laminar and turbulent flow in even, concentric annuli, and the influence of eccentricity is discussed. A good agreement found between the experimentally and the theoretically obtained values of static pressure and the volumetric flow rate in catheterized vessels elucidates a series of features of interest for catheterization praxis and it emphasizes the applicability of relatively simple fluid mechanical equations in flow conditions of medical interest.

Blood Flow Velocity↗

PubMed2001

Renal artery stenosis in minority patients undergoing diagnostic cardiac catheterization: prevalence and risk factors.

BACKGROUND: Atherosclerotic renal artery stenosis (RAS) is a frequently overlooked clinical entity that can cause progressive renal failure and uncontrolled hypertension. Revascularization of a stenosed renal artery is associated with improved clinical outcomes including the prevention of renal failure. Thus, it is important to recognize all potential candidates for renal artery revascularization. In a general population referred for diagnostic cardiac catheterization, RAS of any severity was found in 30% of patients and significant stenosis (> or = 50% diameter narrowing) was found in 15% of patients. The number of minority groups is increasing in the US population, and RAS in this population is not well investigated. Our purpose was to determine the prevalence and risk factors associated with RAS in minority patients referred for diagnostic cardiac catheterization. METHODS: Abdominal aortography was performed in 171 consecutive minority patients referred for diagnostic cardiac catheterization (hispanics = 115, African Americans = 56). The association of clinical and angiographic variables with RAS was examined using univariate and multivariate logistic regression analyses. RESULTS: Renal artery stenosis of any severity was identified in 13.5% of patients (unilateral 7.7%, bilateral 5.8%). Significant RAS was found in 7.7% of patients (unilateral 4.8%, bilateral 2.9%). Independent predictors of RAS included age (mean +/-1SD, 68 +/-10 vs 57 +/-12 yr, P < 0.001, for patients with vs without RAS), coronary artery disease, and elevated serum creatinine levels (> 115 micromol/L). Race/ethnicity (hispanics vs African Americans), sex, smoking, congestive heart failure, diabetes mellitus, peripheral vascular disease, and hypertension were not independent predictors. CONCLUSIONS: Renal artery stenosis in minority patients undergoing diagnostic cardiac catheterization is less common than reported in white patients, is similar in hispanics and African Americans, and is similar in women and men. The clinical and angiographic features are helpful in predicting its presence.

Black or African American↗

PubMed2006

Intermittent catheterization in the rehabilitation setting: a comparison of clean and sterile technique.

OBJECTIVE: To compare the onset of symptomatic urinary tract infection in individuals with spinal cord injury in a rehabilitation setting who are randomized to clean or sterile intermittent catheterization technique. DESIGN: Randomized controlled design. SETTING: Spinal cord rehabilitation units in western Canada. SUBJECTS: Thirty-six patients with cervical spinal cord injuries requiring intermittent catheterization by nursing staff were recruited. None had a previous history of voiding dysfunction or urinary tract infections. INTERVENTIONS: Subjects were randomized to either clean or sterile intermittent catheterization technique. Protocols for both clean and sterile techniques were standardized and followed by nursing staff and caregivers. MAIN MEASURES: Primary outcome measure was symptomatic urinary tract infection as diagnosed by urine culture > or = 10(5) colony-forming units/mL, pyuria (> or =10 leukocytes on high-power field), and accompanying symptoms. RESULTS: A total of 189 urine specimens from 36 subjects were cultured. Of the 36 subjects, 15 (43%) developed a symptomatic urinary tract infection: 6/16 (37%) from the clean group; 9/20 (45%) from the sterile group (P> 0.05). Mean time to onset for symptomatic urinary tract infection for the clean group was 3.0 (standard deviation (SD) 2.4) weeks and for the sterile group, 3.6 (SD 1.3) weeks (P> 0.05). The most common urinary organisms at onset of symptomatic urinary tract infection were Enterococcus species followed by Klebsiella. CONCLUSION: Clean intermittent catheterization in the rehabilitation setting does not appear to place the patient with spinal cord injury at increased risk for developing symptomatic urinary tract infection, and has significant cost and time saving benefits for the health care system, as well as enhancing the transition for the patient from rehabilitation to community.

Adolescent↗

PubMed2003

Hemomediastinum resulting from subclavian artery laceration during internal jugular catheterization.

UNLABELLED: The complications associated with internal jugular vein catheterization are inadvertent arterial puncture, pleural and mediastinal injuries, pneumothorax, hemothorax, and hemomediastinum. Complications caused by laceration of a subclavian artery are rare. We present a case of hemomediastinum resulting from laceration of the subclavian artery during central venous catheterization. After right internal jugular vein catheterization, the left lateral decubitus position was maintained for 6 h during surgery. The severe hypotension was first noted in the supine position after transfer to the postanesthesia care unit. Chest radiograph showed a bulging of the right upper mediastinum. During the upper half sternotomy, a 5-mm long laceration was found at the posteroinferior side of the right subclavian artery near its origin from the innominate artery. IMPLICATIONS: The authors describe the delayed presentation of hemomediastinum resulting from subclavian artery laceration after internal jugular vein catheterization.

Carcinoma, Renal Cell↗

PubMed2006

Sinus of valsalva aneurysm and ventricular tachycardia during pulmonary artery catheterization.

Pulmonary artery catheterization is associated with numerous complications, including serious arrhythmias. We report a case where ventricular tachycardia occurred repeatedly during attempted pulmonary artery catheterization, precluding successful catheterization. Transesophageal echocardiography was used to image the tricuspid valve and right ventricle and revealed a Sinus of Valsalva aneurysm protruding significantly into the right ventricle and obstructing advancement of the pulmonary artery catheter. Our case reveals another identifiable cause of serious arrhythmia during pulmonary artery catheterization and highlights how transesophageal echocardiography can be useful in unanticipated ways during cardiac anesthesia and surgery.

Aortic Aneurysm↗

PubMed1994

Complete atrioventricular block during left heart catheterization.

A 75-year-old male underwent cardiac catheterization for frequent ventricular premature contractions and reduced left ventricular function. ECG on admission showed complete right bundle branch block (RBBB) and left anterior hemiblock. Right heart catheterization was performed uneventfully, but complete atrioventricular block (CAVB) occurred suddenly when a pig-tail catheter was inserted into the left ventricle. Electrophysiological study identified this CAVB as HV block, and demonstrated HV prolongation in sinus rhythm. The coronary angiogram revealed no obstructive lesion or spasm with ergonovine. The reproducibility of the CAVB was demonstrated. The final CAVB developed and persisted for more than one week, requiring the implantation of a permanent pacemaker (DDD). Complete atrioventricular block induced during left heart catheterization is very rare. Pre-existing RBBB with left anterior or posterior hemiblock and reduced left ventricular function may be common factors in patients with this condition. Emergency pacing equipment should always be on-line when left heart catheterization is conducted in such patients.

Aged↗

PubMed1994

A technique for catheterization of the urinary bladder in the ferret.

The technique of catheterization of the urinary bladder, an important clinical skill for the diagnosis of urinary tract disorders, has not been described for the ferret. The bladder was catheterized in 23 ferrets (10 intact females; 11 spayed females; and 2 intact males) using a 3 1/2 French, red rubber urethral catheter fitted with a steel wire stylet. Ferrets were anaesthetized with isoflurane or ketamine (30 mg/kg IM) and xylazine (3 mg/kg IM). Females were positioned in ventral recumbency with the rear quarters elevated by a rolled surgical towel. The urethra was catheterized by direct visualization of the external urethral orifice using a vaginal speculum. The orifice was approximately 1 cm cranial to the clitoral fossa on the ventral floor of the vestibule. Blind passage was used in several spayed females. In males, the distal end of the penis was exteriorized from the prepuce and the external urethral orifice cannulated without stylet. No difficulty was encountered in advancing the catheter past the os penis. This catheterization technique allows urinary tract access for urine collection, pneumocystography, contrast cystography, double contrast cystography, and urine output determination in pharmacologic studies or in critical care of debilitated animals.

Anesthesia↗

PubMed1997

Radiation exposure to children during cardiac catheterization.

The purpose of this study was to assess the suitability of different radiation dosimetry methods and record radiation exposures during paediatric catheterization. Three methods of dosimetry were employed: thermoluminescent dosimetry (TLD), dose-area product and calculation of entrance surface dose from calibrated exposure factors. Examinations included bi-plane fluoroscopy, and cineangiography for diagnosis and treatment of congenital heart disease. The most suitable method of radiation dosimetry for cardiac catheterization is the use of calculated entrance dose or a dose-area product meter. Children were exposed to high levels of radiation during cardiac catheterization but there was a wide variation in radiation dosage. Careful consideration should be given to the suitability of radiation dosimetry for cardiac catheterization.

Adolescent↗

PubMedDate not supplied

Why catheterize?: audit findings on the use of urinary catheters.

Urinary catheters can be associated with complications such as urinary tract infection, pain and discomfort. This article reports on an audit of 51 patients who had a urinary catheter inserted during their hospital stay. Urinary incontinence meant catheterization in 37.5% (n = 27) of cases, with 64.7% (n = 33) being catheterized by nurses. The study highlighted the need for accurate documentation and care planning; 15 patients did not have a plan of care for their catheter and only eight patients had a plan for the removal of the catheter. Catheterization is the most common cause of hospital-acquired infection, and therefore the use of catheters needs careful examination to reduce this type of infection. The question is raised whether catheterization is used as a convenience for nursing staff or as an essential aspect of care.

Attitude of Health Personnel↗

PubMed1995

Intracardiac ultrasound imaging during transseptal catheterization.

STUDY OBJECTIVE: The purpose of this study was to assess the feasibility of using small 12.5- or 20-MHz intracardiac ultrasound catheters to image the fossa ovalis and guide transseptal catheterization. DESIGN: The study was performed in three phases. First, in vitro imaging of human autopsy hearts was performed to define the intracardiac ultrasound appearance of the fossa ovalis and transseptal apparatus. Subsequently, the optimum approach for imaging the fossa ovalis in vivo was established in 30 patients. Finally, intracardiac ultrasound imaging was performed during transseptal catheterization of 10 patients undergoing percutaneous mitral commissurotomy. INTERVENTIONS: Intracardiac ultrasound imaging was performed with a 12.5- or 20-MHz single-element mechanical device in which a central imaging core is rotated within a 6F polyethylene sheath. MEASUREMENTS AND RESULTS: In both in vitro and in vivo studies, the fossa ovalis was easily identifiable as a thin membranous region surrounded by the thicker muscular portion of the interatrial septum. Initial in vivo studies established venous access by the femoral route to be superior to the internal jugular approach for catheter introduction. Studies performed during transseptal catheterization established the utility of using the fluoroscopic image of the catheter adjacent to the fossa ovalis to generate a guiding shot for positioning the transseptal apparatus. In addition, distention of the fossa prior to needle perforation could be demonstrated. However, since it was often difficult to track the tip of the needle, actual puncture of the fossa was rarely demonstrated. CONCLUSIONS: Intravascular ultrasound imaging can precisely locate the fossa ovalis in virtually all subjects. It therefore may assist transseptal catheterization.

Adult↗

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↗

PubMed1988

Continuous oxygen saturation monitoring during cardiac catheterization in adults.

Arterial hypoxemia may contribute to morbidity during cardiac catheterization. Therefore, we measured arterial hemoglobin oxygen saturation (SaO2) continuously using pulse oximetry in 29 patients (age range, 21 to 83 years) undergoing cardiac catheterization. Baseline SaO2 was 96 +/- 0.4 percent. All patients had a decrease in SaO2 at some time during the procedure. Eleven patients (38 percent) had episodes of arterial hypoxemia, defined as a decrease in SaO2 below 90 percent. In these 11 patients, the mean number of episodes of hypoxemia was 16 +/- 7, and the mean duration of each episode was 53 +/- 25 seconds. Multiple stepwise regression analysis showed that the minimum SaO2 during catheterization for any patient was significantly associated with the baseline SaO2, duration of the procedure, and end-diastolic volume (EDV) as described by the following regression equation: minimum SaO2 = 46.8 - 0.0580 (duration of procedure in minutes) + 0.5362 (baseline SaO2) - 0.0159 (EDV). Based on our finding of arterial hypoxemia in greater than one third of our patients, we would consider continuous SaO2 monitoring or supplemental oxygen during cardiac catheterization, especially for those patients with poor ventricular function or low resting SaO2 or those expected to have long procedures.

Adult↗