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PubMed1995

Oximetry catheters in diagnostic heart catheterization in children.

The aim of this study was to assess the performance of pediatric-size oximetry catheters in diagnostic heart catheterization. Measurements of pressures and oxygen saturations were obtained with oximetry catheters as well as with standard methods during routine heart catheterizations in 10 infants and children with congenital heart defects. Maneuverability of the oximetry catheters was comparable to that of standard Swan-Ganz catheters. Pressure tracings were damped, but mean pressures were undistorted. Oxygen saturation measurements exhibited bias and scatter. It is concluded that no advantage is obtained by the use of oximetry catheters in diagnostic heart catheterization in children and infants.

Cardiac Catheterization↗
PubMed1998

Influence of guidewire and catheter type on the frequency of cerebral microembolic signals during left heart catheterization.

Cerebral embolization is a serious complication during diagnostic heart catheterization. To date there have been no studies to determine whether the technique and the catheter type influence the frequency of cerebral microembolic signals (MES's) during left ventricular catheterization. Twenty-two patients had a leading straight tip guidewire protruding 5 to 10 cm outside the coronary catheters when the latter was advanced over the aortic arch (group A), whereas in 21 patients the guidewire was withdrawn in the descending part of the aorta (group B). Transcranial Doppler of the left middle cerebral artery was performed to monitor the number of cerebral MES's. When a protruding guidewire was used to advance the coronary catheters over the aortic arch, MES's were detected in 86% of the patients compared with 29% when the catheters were advanced without a guidewire (relative risk = 4.6, p = 0.00001). The number of MES's per patient also was significantly higher when a guidewire was used (median 9 vs 0) (p = 0.000004). In group A, a higher number of MES's was detected when a right Judkins catheter was advanced over the aortic arch than when a left Judkins catheter was advanced (median 6.5 vs 1) (p = 0.0005) and in patients who previously had a myocardial infarction than in those who had not (median 1 1 vs 4) (p = 0.007). This study strongly suggests that the risk of embolization is greater when straight tip guidewires are used to advance catheters over the aortic arch during left ventricular heart catheterization, especially in patients with a history of myocardial infarction.

Adult↗
PubMed1978

New performed catheter and method for retrograde left atrial or complete left heart catheterization.

Employing a new catheter and technique complete retrograde left heart catheterization was accomplished in 96 of 100 consecutive patients. These 96 patients included 37 with ischemic heart disease, 13 of 17 with isolated aortic valve deformities, 11 with isolated rheumatic mitral valve deformities, 10 with combined rheumatic aortic and mitral valve deformities, and 25 with other problems. The only failures were in 4(of 27) patients with aortic valve deformities. No untoward complications occurred. The retrograde catheterization fluoroscopy time was usually less than 2 minutes. The shortest time was 44 seconds, the longest, 6 minutes and 2 seconds. These data indicate that this new catheterization method achieves safe, reliable (when the aortic valve is not deformed), simple, and rapid complete left heart catheterization. They further indicate it may be useful in assessing patients with mitral stenosis, pulmonary hypertension, hypertrophic obstructive cardiomyopathy, and left-to-right shunt problems.

Cardiac Catheterization↗
PubMed1995

Respiratory and haemodynamic modifications during right heart catheterization in COLD patients.

Noninvasive measurement of the systolic time intervals is a routine procedure for the determination of myocardial performance, even in subjects without clinical or electrocardiographic signs of cardiopathy. Statistically significant differences in pre-ejection period (PEP) and PEP/left ventricular ejection time (LVET) between days and between observations were demonstrated by Levi et al. A high correlation between systolic time intervals and catecholamines was recorded. The aim of the present study was to evaluate the spontaneous modifications in pulmonary and cardiac parameters during a stressful situation, such as right heart catheterization. Seventeen patients with chronic obstructive lung disease (COLD) underwent right heart catheterization. Heart rate (HR), systemic artery pressure (SAP), pulmonary artery pressure (PAP), cardiac output (Q'c), cardiac index (CI), systolic stroke volume (SV), respiratory rate (RR), minute ventilation (V'E), oxygen consumption (V'O2), carbon dioxide production (V'CO2), their ratio (RQ), arterial and venous O2 and CO2, systolic time intervals (total electromechanical interval (QS2), LVET, PEP, PEP/LVET), total pulmonary resistance (TPR), adrenaline (A), and noradrenaline (NA) were recorded at the beginning of the test and 20, 40, 60 and 80 min thereafter. Analysis of variance (ANOVA) showed significant differences between the observations for systolic pulmonary artery pressure (SPAP), Q'c, V'O2, V'CO2, V'E, PEP/LVET, and NA. In conclusion, it is necessary to take into account spontaneous modifications in pulmonary haemodynamic parameters following a stressful situation, such as a catheterization, when studying the effects of drugs such as vasodilators and vasoactive agents.

Cardiac Catheterization↗
PubMed2006

Percutaneous left and right heart catheterization in fully anticoagulated patients utilizing the radial artery and forearm vein: a two-center experience.

BACKGROUND: Stopping oral anticoagulants prior to cardiac catheterization is associated with an increased risk of thromboembolism. Performing the procedures via the femoral artery and vein without interruption of anticoagulation is associated with a high rate of major access site complications. The transradial technique for left heart catheterization is safe in fully anticoagulated patients but few data are available on the percutaneous right and left heart catheterization utilizing a combination of the radial artery and antecubital vein in this group of patients. METHODS: We report our experience in 28 consecutive patients that underwent left and right heart catheterizations via this percutaneous arm approach without interruption of anticoagulation. These were compared to 31 consecutive non-anticoagulated patients that underwent the procedure via a conventional femoral artery and vein approach. RESULTS: Arterial and venous accesses were achieved and complete angiographic and hemodynamic data obtained in all patients. There were no access site complications in the anticoagulated patients despite an International normalized ratio (INR) of 2.5 +/- 0.5. Procedural duration was longer in the anticoagulated group of patients, but fluoroscopy time and patient radiation dose were similar in both groups. CONCLUSION: Our experience suggests that left and right heart catheterization can be safely performed in most fully anticoagulated patients using this technique with a low bleeding and thromboembolic risk and no increase in radiation exposure.

Anticoagulants↗