BACKGROUND: Transseptal catheterization is the key to a successful percutaneous balloon mitral valvuloplasty (PBMV). The primary aim of the study was to investigate new methods of transseptal catheterization for PBMV. METHODS: Eighty-four patients with rheumatic mitral stenosis were randomized into two groups for PBMV. In the study group, the left ...

Pulmonary embolism (PE) and deep venous thrombosis (DVT) remain major problems in medicine that receive less attention from healthcare professionals and the public than either coronary artery disease or acute myocardial infarction. Furthermore, strategies proven to minimize the frequency of PE and DVT are not widely employed on a consistent ...

OBJECTIVE: To evaluate the safety of a propofol-ketamine mixture to induce and maintain anesthesia in spontaneously breathing pediatric patents during cardiac catheterization. DESIGN: Prospective clinical study. SETTING: Departments of Cardiothoracic Surgery, Anesthesiology, and Pediatric Anesthesiology in a university hospital. PARTICIPANTS: Forty-five children aged 6 months to 16 years with ASA ...

Each year, approximately 650,000 persons have a first heart attack in the United States. Heart attack survivors are at increased risk for recurrent heart attacks, cardiovascular complications, and sudden cardiac death. A major component of risk-reduction strategies for these patients is cardiac rehabilitation consisting of nutritional counseling; management of lipid ...

AIM: The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction. RATIONALE: Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception ...

BACKGROUND: Patients who have been treated for coronary heart disease can enroll in traditional cardiac rehabilitation, the Ornish Program, or no rehabilitation at all. No study has compared the impact of each on cardiovascular disease risk (CVD) factors. METHODS: The current study compared CVD risk changes in post coronary artery ...

Nine hundred sixty consecutive cardiac catheterization procedures were studied prospectively for the presence of periprocedural bacteremia. Overall, among 960 procedures, only 4 were associated with clinically significant bacteremia. All 4 were related to the intravenous line and none to the cardiac procedure itself. Clinically nonsignificant bacteremias were correlated with procedural ...

To examine the effects of patient education on anxiety among Chinese patients with heart disease undergoing cardiac catheterization in Hong Kong. Randomized experimental design, data collected on three occasions from subjects. A regional major hospital in Hong Kong. 62 clients who met the inclusion criteria were randomly allocated into experimental ...

BACKGROUND: Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac ...

OBJECTIVE: The current study examined predictors of, and reasons for, non-attendance at cardiac rehabilitation (CR) among coronary heart disease patients. METHODS: Measures of demographics, surgical procedures, cardiac risk factors, cardiac damage, and psychological variables (depression, trauma, anxiety and alexithymia) were obtained at baseline in 85 coronary heart disease patients, of ...

Fetal cardiac interventions are relatively new and promising therapeutic options for modifying CHD in utero. Techniques for safe access to the fetus must be improved and patient selection criteria must be developed. Most important is early detection and referral of all patients who have CHD, enabling improved outcomes for infants. ...

OBJECTIVES: To examine (1) risk factors for urinary tract infection (UTI) during stroke rehabilitation and (2) the relation of postvoid residual (PVR) to the frequency of UTI. DESIGN: Prospective case series. SETTING: Academic specialty stroke rehabilitation service. PARTICIPANTS: One hundred one consecutive admissions for stroke rehabilitation. INTERVENTIONS: Not applicable. Main ...

We studied 50 consecutive patients with relatively preserved systolic function (ejection fraction >40%, mean 53 +/- 11%) after acute myocardial infarction, and assessed indexes of dispersion of ventricular repolarization before and after a formal, phase II cardiac rehabilitation and exercise training program. After cardiac rehabilitation, statistically significant reductions occurred in ...

Cardiac rehabilitation was originally conceived to counteract the deconditioning and comorbidities associated with prolonged bed rest after a myocardial infarction. Contemporary cardiac rehabilitation has taken a more comprehensive approach, with a broader range of participating patients. Relevant cardiovascular outcomes of cardiac rehabilitation can be classified as primary clinical outcomes, intermediate ...

Diffusion tensor MR imaging (DTI) provides information on diffusion anisotropy, which can be expressed with three-dimensional (3D) white matter tractography. We used 3D white matter tractography to show the corticospinal tract in eight patients with acute or early subacute ischaemic stroke involving the posterior limb of the internal capsule or ...

This review discusses the scientific and clinical evidence for cardiac rehabilitation in patients who have undergone percutaneous revascularization, heart transplant, and heart valve surgery, and in patients with chronic heart failure. Across these diagnoses, regardless of age, there is considerable benefit of cardiac rehabilitation and supervised exercise training for increasing ...

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 ...

The number of aged individuals is growing, and consequently the demands on resources for cardiac surgery will increase in the elderly. Even in the absence of obvious coexisting diseases, advanced age is always accompanied by a general decline in organ functions, and specifically by changes in structure and function of ...

Murine studies have been a mainstay of analyzing the effects of genetic manipulation on cardiac phenotype. Reliable and efficient methods to evaluate cardiac phenotype are necessary and need to be established. However, cardiac catheterization techniques for obtaining such data have not been standardized. The goal of this study was to ...

Psychological issues surrounding the care of patients with cardiovascular disease are many and diverse. This paper discusses three main areas: cognitions, emotions, and social support. The examples given relate primarily to post-myocardial infarction patients but the concepts discussed are relevant to other aspects of cardiovascular disease. Patients' cognitions can influence ...

Vascular complications after cardiac catheterization are rare and usually occur at the access sites. However, vessels along the tract of the catheter can also be injured, causing bleeding and hematoma formation. We present a 57-year-old male who underwent cardiac catheterization via the radial approach, later developing neck and mediastinal hematoma, ...

GOAL: To investigate the incidence of early (< 24 hours) and late (> 24 hours to 7 days) reactions to 3 contrast agents commonly used in cardiac catheterization. METHODS AND RESULTS: A total of 2,108 patients undergoing cardiac catheterization in a Regional Cardiothoracic Unit were randomly assigned to receive 1 ...

This study examined the hypothesis that Phase II cardiac rehabilitation participants (CRP) had better long-term risk factor control, self-rated perception of health and return to work rates than non-participants (NP) between 18 and 36 months post myocardial infarction (MI). It was a comparative study in a 550 bed hospital. Approximately ...

The efficacy and safety of ultrasound guidance to obtain transhepatic access for cardiac catheterization were investigated in this study. The transhepatic route for access to perform cardiac catheterization has become an acceptable alternative when conventional routes of access have failed. However, the use of ultrasound to guide transhepatic access has ...

The aim of this study was to compare the effects of residential multifactorial cardiac rehabilitation, outpatient multifactorial rehabilitation, stress management, and standard coronary rehabilitation, on cardiac risk reduction. Out of 144 eligible male patients recently treated with percantaneous transluminal coronary angiography (PTCA), coronary artery bypass graft (CABG), or acute myocardial ...

PURPOSE: This study examined the relationships between physiologic function, depressive symptoms, and body image among maintenance cardiac rehabilitation participants. Physiologic function was operationalized as both functional status and functional capacity. METHODS: Participants were 72 men (mean age = 67.3 years) all of whom had experienced a traumatic cardiac event (ie, ...

BACKGROUND: Health-related quality of life (HRQL) assessment is an important measure of the impact of a wide range of disease process on an individual. To date, no HRQL tool has been evaluated in an Iranian population with cardiovascular disorders, specifically myocardial infarction, a major cause of mortality and morbidity. The ...

Considerable uncertainty exists about the role that will be played by cardiac surgery for acquired heart disease in the coming decade. In many institutions the volume of surgery for ischemic heart disease has already been affected by advances in interventional cardiology; the impact of those advances can only increase with ...

BACKGROUND: Prior studies have reported race and sex differences in cardiac catheterization use after acute myocardial infarction (AMI). It is unclear whether race or sex differences in procedure refusal may contribute to this difference. We sought to determine whether cardiac catheterization refusal rates differ by patient race or sex. METHODS: ...

Research has shown that patients' models of illness are likely to be different from those of health professionals and that these beliefs may be more important than medical factors in directing the recovery process. Beliefs about myocardial infarction may influence coping with the illness, expectations for recovery, patients' reactions to ...

BACKGROUND: The outcome after myocardial infarction may be influenced by the type of physician providing ambulatory care. METHODS: We studied 35,520 patients 65 years of age or older who were hospitalized for myocardial infarction in seven states during 1994 and 1995 and who survived for at least three months after ...

PURPOSE: To examine the effectiveness of cardiac rehabilitation on health status following coronary artery bypass surgery. METHODS: A prospective cohort study of patients having coronary artery bypass surgery at 14 centers in the state of Washington. Baseline clinical and demographic data were collected, as was information from the Rand Short ...

OBJECTIVES: To investigate the level of cardiovascular stress of physical therapy (PT) and occupational therapy (OT) sessions of a contemporary stroke rehabilitation program and to identify therapeutic activities that elicit heart rate responses adequate to induce a training effect. DESIGN: A descriptive, longitudinal study with heart rate and activity monitoring ...

BACKGROUND: Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published. AIMS: To ...

With an ageing population and a decline in cardiac mortality rates, the number of patients with cardiac disease is increasing, which in turn poses a major challenge for secondary prevention. For this end, appropriate, sensitive, and validated instruments to assess health complaints and quality of life are required. The objectives ...

BACKGROUND: Predicting the risk of cardiac and all-cause death in patients with established coronary heart disease is important in counseling the individual and designing risk-stratified rehabilitation and secondary prevention programs. Cox proportional hazards and Kaplan-Meier survival curves were thus completed on initial assessment data obtained from patients referred to an ...

Central venous access is important in both assessment and treatment of the patient. In modern clinical practice, a percutaneous approach is preferred. The well-established subclavian and internal jugular vein catheterization techniques, however, still carry the risk of major acute complications. In this article we describe a trial study of a ...

Cardiovascular disease (CVD) is the leading cause of death and disability for women and men. There are gender differences in recovery from coronary events, which may be due physiological, sociodemographic, or psychosocial factors. Cardiac rehabilitation programs have beneficial effects on coronary recovery. The following presents a review of the literature ...

Although workplace supervisors may play a significant role in the return-to-work process, there are very few scientific references to this effect. This study surveyed supervisors' reactions, attitudes, and anxieties concerning the return-to-work of employees after myocardial infarction or coronary artery bypass graft. A total of 58 supervisors of employees who ...

A very large number of Americans die from Coronary heart disease (CHD); a large number survive. It is the goal of cardiac rehabilitation to restore the physical and economic status of individuals suffering from CHD. This paper reviews current CHD statistics, summarizes the factors that are known to cause CHD, ...

Continuous chronic drug infusion with PGE1 via a portable pump and neuromuscular electrical stimulation (NMES) help to improve the quality of life in patients with severe chronic heart failure waiting for a donor heart, as both treatments can be performed at home. We report a 56-year-old woman suffering from severe ...

BACKGROUND: The study was performed to examine the effects of giving patients with acute myocardial infarction an advice and relaxation audio tape within 24 h of admission to hospital. METHODS: A prospective, two-group design was used with 243 subjects randomised to receive either the advice and relaxation tape or a ...

The focus of this study was to describe changes the patients make in eating and weight control habits 3--4 months after diagnosis of myocardial infarction, and to identify difficulties associated with the reported changes 1 month later. Subjects were 50 male patients (mean age 48 years, mean body mass index ...

BACKGROUND: South Asian people living in the United Kingdom are at increased risk of coronary heart disease, have higher mortality rates and are less likely to be treated when compared to the white population. There is, however, little information about the experiences and needs of this group after discharge from ...

Diagnostic interpretation of intraoperative transesophageal echocardiography (TEE) examinations may vary, particularly when the echocardiographer is also the anesthesiologist. We therefore evaluated the concordance of TEE interpretation as part of a process of continuous quality improvement (CQI). Ten cardiac anesthesiologists participating in a CQI program conducted 154 comprehensive TEE examinations, each ...

Associations of age, gender, cardiac procedure (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty), risk stratification, and number of comorbidities with health-related quality of life (HRQL) were examined among 217 men and 84 women (mean age, 63+/-11 years) consecutively enrolled in a phase II cardiac rehabilitation program. Female gender ...

Claims have been made that left-handedness often arises from pathological causes, and that owing to this underlying pathology, the presence of sinistrality may entail disadvantages for both the length and quality of life. A prime implication of these claims is that left-handers, as a group, should display signs of poorer ...

The objectives of this study were to disclose and to reduce occupational radiation leakage in invasive cardiology. Prospectively, we analyzed various dose parameters for 330 coronary procedures. We used a Rando phantom to measure scatter entrance skin air kerma to the operator (S-ESAK-O) during fluoroscopy for all standard tube angulations, ...

We evaluated free-breathing, prospective navigator-gated, three-dimensional (3D) magnetic resonance coronary angiography (MRCA) with hybrid ordered phase-encoding (HOPE), in the detection of proximal coronary artery stenosis. The coronary arteries were imaged in 46 patients undergoing cardiac catheterization. The mean scan time was 48 minutes. The mean arterial length (mm) visualized was ...

AIMS: The one-year effects of early and short-term intensive cardiac rehabilitation programmes in patients after acute myocardial infarction or coronary artery bypass surgery (CABG) are not well established. METHODS AND RESULTS: One to four weeks after hospital discharge for acute myocardial infarction (n=55) or CABG (n=54), 109 patients were included ...