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 ...

We describe a case of a woman with severe vascular disease in whom retrograde access to the aortic root was limited by both aortoiliac and axillary disease. Transseptal catheterization was performed in anticipation of percutaneous aortic valvuloplasty. Selective antegrade angiography was successfully performed using catheters introduced through the transseptal sheath.

We evaluated a new hemostasis device to maintain focused pressure over the femoral artery puncture site for 2-6 hours in 330 cases after diagnostic catheterization or coronary angioplasty. No patient developed later hematoma or vascular complications. The initial favorable experience suggests that this hemostasis device has advantageous features of stability ...

A Doppler guided retrograde catheterization system was developed to accurately catheterize the aortic root and left ventricular chamber without X-ray. This system consists of a 20 MHz, 0.076 mm thick x 1.016 mm diameter pulsed Doppler crystal integrated into the tip of a 100 cm multipurpose triple lumen catheter. Two ...

Although antegrade ureteral catheterization is best approached from a middle or upper middle calix for the most favorable force vector, it is occasionally necessary to use a lower pole caliceal approach. A catheter technique is described for completing antegrade ureteral catheterization via the lower pole calix when conventional catheter-guidewire combinations ...

Of 13,203 transfemoral diagnostic and therapeutic cardiac catheterization procedures performed between January 1, 1980 and December 31, 1990, 73 (0.55%) were complicated by pseudoaneurysm (PA) formation, and 15 (0.11%) by arteriovenous fistulas (AVF). The rate of PA increased progressively from 0.44% (1980-1987), to 0.59% (1987-1989), to 0.92% (1990), with no ...

A new prototype transesophageal transducer with continuous-wave Doppler and pulsed Doppler capabilities was evaluated to calculate intraoperative cardiac output from the main pulmonary artery. Fifteen consecutive patients undergoing elective coronary artery bypass surgery were studied. The main pulmonary artery diameter above the pulmonic valve was measured with the single horizontal ...

Two newborn infants with transposition of the great vessels and an intact ventricular septum were cyanotic when they underwent bedside balloon atrial septostomy in the neonatal intensive care unit. The procedure was conducted under direct transesophageal two-dimensional echocardiographic guidance. Success of the procedure was evaluated with color flow Doppler and ...

Accelerated coronary ostial stenosis is an infrequent late complication of coronary artery catheter instrumentation during aortic valve surgery, PTCA, or coronary angiography. We report the first case of bilateral coronary artery ostial stenoses developing after cardiac catheterization and right coronary artery PTCA. In patients with worsening angina following cardiac catheterization ...

To study the effect of monosodium glutamate on hemodynamics and on substrate metabolism in cardiac and skeletal muscle, an intravenous (IV) dose of 1.2, 2.5, or 5.0 mg/kg body weight was administered to 27 patients during arterial-coronary sinus catheterization (15 patients) or arterial-femoral vein catheterization (13 patients). Data were obtained ...

Bedside pulmonary artery catheterization has proven to be an important addition to the clinical assessment of critically ill patients. Properly used, the procedure may provide hemodynamic information that is not apparent from physical examination or radiography. It may be safely accomplished through various venous routes, but care must be taken ...

We report a 52-year-old man who presented with cardiac tamponade a few years after accidental breakage of an acupuncture needle that had not been removed. Thoracotomy showed a hemopericardium with penetration of the pulmonary artery by the very fine needle which was barely detected on the chest roentgenogram. This lesion ...

Technologic advances in echocardiography (e.g., better spatial resolution, Doppler, and color flow mapping) have improved our ability to demonstrate anatomy and physiology in previously problematic conditions, precluding catheterization and angiography in some instances. However, diagnostic catheterization remains necessary in other instances. The aims of this study were to determine whether ...

The authors present a technique of longterm lingual artery catheterization for intraarterial regional chemotherapy. The transtemporal approach enables safe introduction through the external carotid artery. Catheterization technique is presented in 16 patients with the diagnosis of carcinoma baseos oris and carcinoma linguae. Both the lingual arteries were infused in four ...

Bilateral aortoiliac pressure measurements were obtained at the time of aortography by performing contralateral iliac artery catheterization in 102 patients with peripheral vascular disease. Patients studied had mild-to-moderate aortoiliac disease and in their cases the additional information was believed to be important in therapeutic decision making. Patients with severe ulcerative ...

Jugular bulb catheterization (JBC) provides cerebral venous access for titration of brain-specific therapy. Little has been written about the catheterization procedure. We prospectively studied the time, number of punctures, success rate, and complications during JBC for a 24-month period in our ICUs. One hundred twenty-three patients (mean age 6.7 yr, ...

Femoral arterial complications following cardiac catheterization have been well recognized. The development of an inguinal mass in these patients can represent a simple hematoma, a pseudoaneurysm, or an arteriovenous fistula. The utility of the physical examination in diagnosing these complications was assessed by using the echo Doppler study for comparison. ...

Brachial artery thrombosis may be encountered after cardiac catheterization using the Sones technique. Differing opinions have been reported regarding the optimal management of this injury. During the past five years, 20 patients have had surgical repair of the brachial artery after trauma from cardiac catheterization. Satisfactory results have been obtained ...

A prospective study of 126 surgical patients from two institutions was undertaken to assess the impact of pulmonary artery catheterization in surgical intensive care units. Before catheterization, surgical residents were asked to predict pulmonary artery wedge pressure, cardiac output, systemic vascular resistance, and plan of therapy. After catheterization, each chart ...

A method is described for comprehensive hemodynamic study of undisturbed baboons (Papio hamadryas) that incorporates cardiac output measurement by thermodilution. Instrumentation includes arterial, aortic, and central venous catheterization by a surgical technique that does not require entry to peritoneal or thoracic cavities. It provides a means for right atrial indicator ...

We describe 3 patients with cholesterol embolization after left heart catheterization via the femoral route. The left catheterizations were performed via the femoral route in all reported cases in which cholesterol embolization occurred as a complication of left catheterization. Postmortem examinations reveal that PTCA, using the right brachial approach, is ...

We describe an 82-yr-old patient with platypnea-orthodeoxia without identifiable lung disease in whom the diagnosis was suspected because of clinical history, echocardiography, and orthostatic measurement of arterial blood gases. Recumbent and upright cardiac catheterization techniques confirmed the presence of orthostatic variation in the degree of right to left shunt across ...

In seven patients with symptomatic atrial fibrillation and uncontrollable ventricular rates, selective catheterization of the atrioventricular (AV) nodal artery was performed to chemically destroy the AV node. Ethanol at a concentration of 96% and a dose of 0.5-2 ml was used after selective catheterization of the AV nodal artery had ...

A patient with tuberculous pericardial effusion is described who presented with cardiac tamponade. Subsequent to pericardiocentesis, a large echodense intrapericardial mass was observed which disappeared completely with antituberculous chemotherapy. The resolution of the mass suggests that it was a conglomeration of fibrinous exudates deposited in the pericardial cavity. Presence of ...

Fifty-eight children who underwent diagnostic femoral artery catheterization before 5 years of age, from 5 to 14 years before the study, were randomly selected from approximately 300 surviving patients undergoing diagnostic femoral artery catheterization at our institution during the interval. Each patient underwent vascular laboratory segmental pressure and waveform examination ...

The validity of cardiac output measurement by thermodilution in the lateral position during thoracotomy was assessed. Three balloon thermodilution Swan-Ganz catheters were placed in the pulmonary artery trunk and the right and left pulmonary arteries in 12 mongrel dogs, after left thoracotomy had been performed. Cardiac output was measured simultaneously ...

Femoral vein catheterization has advantages over subclavian vein catheterization during cardiac arrest in that there is minimal interference to ongoing CPR. In addition, risks of subclavian catheterization are not a factor in femoral vein catheterization. Few studies have compared the success rate for catheterization of one site with that of ...

Aortopulmonary window coexisting with tetralogy of Fallot (TF) was prospectively diagnosed by two-dimensional (2D) echocardiography and Doppler in an 18-month-old boy; the diagnosis was confirmed by cardiac catheterization and angiocardiography. Surgical correction was performed, but the patient died in the operating room from right ventricular dysfunction. The autopsy showed an ...

Hemangiomas are uncommon primary tumors of the heart. Most of them are found incidentally at autopsy, during clinical evaluation, or cardiac surgery. Occasionally, a protean clinical picture is manifested, including valvular disorder, arrhythmias, obstruction of coronary artery and other significant vasculature, pericardial effusion, and embolic phenomena. Catheterization, angiography, and echocardiography ...

Cardiac surgery in 602 children was not preceded by cardiac catheterization, the diagnosis being based on clinical findings and two-dimensional and Doppler echocardiography. In the 355 operations without cardiopulmonary bypass there were nine major and seven minor diagnostic errors (2.5% and 2%). Among the 247 cases with open-heart surgery there ...

This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 +/- 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was ...

Pulmonary arterial pressure predicts survival in patients with hypoxic chronic obstructive pulmonary disease as does the presence of cor pulmonale. Thus, cardiac catheterization has been performed prior to treatment for long-term oxygen therapy (LTOT) in order to 1) assess the suitability of patients for LTOT, 2) predict survival in patients ...

Catheterization of the left atrium can provide valuable information about both congenital and acquired heart disease. The traditional approach to examination of the left atrium has been the transseptal route, which has occasionally been associated with serious complications. A method of retrograde left atrial catheterization has been developed that is ...

A newborn infant with a history of umbilical artery catheterization had renal vascular hypertension and congestive heart failure. An abdominal ultrasound examination revealed aortic thrombosis extending from the celiac axis to the aortic bifurcation. Retroperitoneal aortic thrombectomy was performed without difficulty. The infant's hypertension and cardiac failure resolved. The retroperitoneal ...

The arterial switch procedure has become an accepted reparative technique for transposition of the great arteries with or without ventricular septal defect. In this study the accuracy of prospective noninvasive imaging in detecting arterial tract obstruction and the prevalence and severity of arterial valvular regurgitation (as assessed by Doppler ultrasound) ...

Doppler echocardiographic assessment of the aortic valve area (AVA) using the continuity equation was performed before cardiac catheterization in 100 patients with suspected aortic stenosis. Doppler echocardiographic AVA correlated closely with AVA calculated by the Gorlin equation at catheterization (r = 0.96). However, Doppler echocardiography slightly but systematically underestimated the ...

Selective catheterization and angiography of brachiocephalic vessels in the elderly may be difficult because of tortuosity and unfolding of the thoracic aorta. Use of a special guide wire contributed to the successful performance of safe femorocerebral angiography with the Simmons sidewinder catheter in the 47 of 48 elderly patients in ...

A technique for performing retrograde catheterization of the left atrium followed by double balloon mitral valvuloplasty without transseptal catheterization is described. Three patients have undergone double balloon mitral valvuloplasty by means of this technique, all with marked improvement in postdilatation mitral valve areas. The technique avoids iatrogenic atrial septal defects ...

Doppler color flow and two-dimensional ultrasonographic images of the femoral region were obtained in 25 patients referred for suspected vascular complications of cardiac catheterization. Five patients had normal findings, while 23 abnormalities were noted in 20 patients, including seven femoral arteriovenous fistulae, 12 femoral pseudoaneurysms, and two patients with both ...

A new guidewire constructed from kink-resistant titanium-nickel alloy, polyurethane, and hydrophilic polymer is described. We have used this wire in 119 angiographic and 49 interventional procedures without complications. In numerous applications, it offers significant advantages over other guidewires. It is particularly helpful for angiography and interventional procedures requiring catheterization through ...

Brachial artery catheterization via cutdown and a direct needle puncture was evaluated in 369 patients undergoing arteriography at the authors' medical center from January, 1970, to March, 1988. The indications for retrograde brachial arteriography were absence of palpable femoral pulses, failure of a femoral approach, previous aortic bypass surgery, and/or ...

Twenty-three cases of arterial injury after 8,208 arterial catheterizations for diagnostic or therapeutic indications at Glasgow Royal Infirmary are reviewed. Clinical presentation included haematoma formation, development of an acutely ischaemic limb or a false aneurysm. Patients with valvular heart disease are identified as a high risk group. Nine cases were ...

The need for the prophylactic insertion of a pacemaker before pulmonary artery catheterization in patients with pre-existing left bundle-branch block (LBBB) is controversial. To determine the incidence of new right bundle-branch block (RBBB) and complete heart block during bedside pulmonary artery catheterization, 293 patients undergoing 307 pulmonary artery catheterizations were ...

A 1 1/2-year-old female patient with atrial and ventricular septal defects and severe pulmonary arterial hypertension was found to have discrete stenosis of left upper and middle lobe pulmonary veins. The diagnosis was made by cross-sectional and Doppler echocardiography. The findings were confirmed at cardiac catheterization and operation. Pressure gradients ...

Atheromicroembolism after aortic or cardiac catheterization is frequently found at autopsy but rarely recognized in life, perhaps because many cases are asymptomatic. We report two patients who, after left heart catheterization, developed gastrointestinal hemorrhage from a solitary colonic ulcer caused by occlusive atheromicroemboli in submucosal vessels. We briefly review the ...

The decision to use bedside pulmonary artery catheterization for managing patients must involve a careful assessment of the risks compared to the benefits. Complications can be minimized by following specific guidelines for catheter insertion and maintenance. Pulmonary artery catheterization has been shown to be more accurate than clinical assessment alone ...

Thirty-two patients suffering from high-grade glioma were candidates for superselective cerebral arterial infusion of 1,3-bis-(2-chloroethyl)-1-nitrosourea (BCNU) after surgery and radiation therapy. There were 74 catheterizations using an 8-French guiding catheter through which a 2.5-French balloon catheter was placed into the main arterial trunk feeding the tumor. Eleven procedures were abandoned ...

A directional needle with a closed pencil-point tip and a distal side hole was developed to permit antegrade guide wire placement by way of a 90 degrees puncture angle. It has been used in over 25 patients without technical difficulties or complications. It has been very effective for catheterization of ...

For many years, the pulmonary artery catheter has been used to monitor cardiac filling pressures and to determine cardiac output in hemodynamically unstable patients. Recently, a new pulmonary artery catheter with fiberoptic capabilities, which provides continuous mixed venous O2 saturation (SvO2) measurements, has become available and has been found to ...

The obstetric literature reflects an increased interest in invasive hemodynamic monitoring during the past decade. While much of this interest has focused on research applications, the patient with severe preeclampsia may benefit clinically from pulmonary artery catheterization under several circumstances. These conditions include severe hypertension unresponsive to conventional antihypertensive therapy, ...