The aim of this study was to demonstrate that total hemodynamic evaluation of patients with aortic regurgitation can be performed on an outpatient basis by combining right heart catheterization with digital subtraction angiography (DSA). Thirteen patients with severe aortic regurgitation were catheterized as outpatients, without premedication. The pulmonary artery was ...

We examined ten patients who, from 1981 to 1986, sustained neuro-ophthalmologic events during cardiac catheterization. Eight patients, most of whom recovered, were believed to have sustained embolic phenomena. Two patients experienced a typical migraine during the catheterization and likewise did well. We conclude that the likelihood of sustaining a neuro-ophthalmic ...

Most studies dealing with the arterial system impedance as resistance to blood ejection from the left ventricle are based on catheterization examinations of the aorta and the great arteries. The present work shows the possibility of using non-invasive approaches and describes one of them consisting in non-invasive determination of arterial ...

A case of an accidental placement of the introducer sheath of a Swan Ganz catheter into the right lymphatic duct during right internal jugular vein catheterization is presented. This rare complication has to be reported, because the choice of the right internal jugular vein for central venous catheterization has been ...

Selective intra-arterial digital subtraction angiography of the brachiocephalic arteries using the right brachial artery approach was successfully performed for 169 of 173 patients, 33 of whom were outpatients. Catheterization was unsuccessful for four patients; two of them elderly hypertensive men with tortuous brachial arteries, and two of them middle-aged obese ...

A neonate developed aortic thrombosis following catheterization of the umbilical artery. The thrombus was identified and followed up by ultrasonography. Fibrinolytic therapy led to the almost complete disappearance of the aortic thrombus but the child died of cerebral haemorrhage. Physicians should be alerted to the possibility of aortic thrombosis in ...

Traumatic aortic lacerations are life-threatening injuries that require a prompt diagnosis and surgery if patients are to survive. Most authors recommend transfemoral catheterization when performing thoracic aortography in patients with suspected aortic lacerations. The authors of this study describe two patients in whom transfemoral catheterization and contrast material injection were ...

We examined the incidence of complete heart block (CHB) as a complication of pulmonary artery catheterization with balloon-tipped, flow-directed catheters in patients with left bundle-branch block (LBBB). The study group included 47 consecutive critically ill patients with LBBB in the medical intensive care and coronary care units, who underwent a ...

In a patient with a large pericardial effusion without any clinical signs of cardiac tamponade, echocardiography revealed collapse of the right ventricle and prolonged (greater than 34%) inversion of the free wall of both atria, maximal in early systole. The presence of such findings in the absence of clinical signs ...

Percutaneous balloon aortic valvuloplasty (PAV) has been reported in children and in selected adults with aortic stenosis using retrograde arterial catheterization. Some patients, however, cannot undergo retrograde catheterization because of atherosclerotic disease, previous vascular surgery or the presence of vessel tortuosity. Because PAV requires the use of large balloon dilating ...

A dog was examined because of cardiac tamponade secondary to pericardial effusion. Masses adjacent to the right atrial and ventricular walls were revealed by echocardiography. Pericardectomy and biopsies of the masses established the diagnosis of idiopathic hemorrhagic pericardial effusion with organized thrombi. The dog was healthy 3 months after surgery. ...

In 12 patients requiring pulmonary artery catheterization, cardiac output was measured using Doppler and thermodilution techniques. The Doppler technique accurately predicted measurements made by thermodilution (r = 0.91; P less than .001). Eighteen normal patients in the third trimester and 36 preeclamptics who had not been treated with medications other ...

Factors influencing the rate of post-catheterization venous thrombosis were studied in 180 infants below one year of age. The initial cardiac catheterization was performed either with cutdown technique or percutaneously. At repeat catheterization on the ipsilateral side presence or absence of thrombosis was noted. The overall thrombosis frequency was higher ...

Three commercial vessel dilators and a dilator of an improved design were tested during percutaneous catheterization in 16 mongrel dogs to evaluate arterial damage produced with their use. The results indicate that, although all dilators often produce arterial damage, the improved design produced much less damage. In addition, lesions were ...

Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guidewire in an anterior direction. Antegrade catheterization of ...

A technique for catheterizing male small ruminants is described. The barrier formed by the presence of the urethral diverticulum is avoided by the use of a pre-curved catheter. The technique enables application of contrast studies of bladder and urethra in animals suspected of urolithiasis. Differentiation between cystitis and obstructive urolithiasis ...

Measurement of cardiac output (CO) requires right-sided cardiac catheterization. However, to save time and reduce costs, only left-sided cardiac catheterization is usually performed in most patients with suspected coronary artery disease. Thus, CO is not measured. To determine if CO can be measured from the left side of the heart, ...

Some current trends in the management of neurogenic bladder have been toward utilization of the urinary bladder as a storage device with a continent catheterizing stoma. This study presents a procedure using the now standard Cohen ureteral reimplantation, followed some 6 weeks later by transureteroureterostomy and distal ureteral stomal formation, ...

The axillary vein route was investigated prospectively for percutaneous pulmonary artery catheterization in 79 patients who underwent 83 attempts. Forty nine of these patients were tracheostomized and under mechanical ventilation and eight had hemostasis disorders. Successful catheterization was achieved 74 times in the 79 patients. Pulmonary artery was reached within ...

During a 3-year period, 12,158 cardiac catheterizations were performed via the brachial artery. During this same period, 106 patients were operated on for complications of brachial artery injury and/or thrombosis, an incidence of 0.9%. The indication for the cardiac catheterization was coronary artery disease in almost 92% of the patients. ...

The frequency of arterial trauma or hematoma can be reduced by using smaller puncturing needles (21-gauge) and catheters (4- or 5- French). Versatile ultrafine guide wires are now available for selective and superselective catheterization. This miniaturization of angiographic equipment allows many vascular procedures to be performed safely on an outpatient ...

We describe modifications and suggestions for safer percutaneous catheterization of the brachial artery based in part on the anatomy of the axillary-brachial artery and surrounding nerves of the brachial plexus. The brachial artery approach should be nearly as safe as the femoral artery approach for percutaneous catheterization and should not ...

To determine how useful pulmonary artery catheterization is in abdominal aortic surgery and which patients are most likely to benefit from the procedure, the author studied 28 patients with aneurysms and 22 with obstructive disease. Patients with multiple risk factors, except those with leaking aneurysms, were assessed before operation by ...

During 1983 and 1984, 1305 patients underwent 1,400 pulmonary artery (PA) catheterizations. Successful placement was achieved in 1397 (99.6%) of 1,403 attempts. The catheters were inserted via the right internal jugular vein on 1364 occasions. The median duration of monitoring was 28 h with a range from 3 to 220 ...

In our institute, 1100 patients with a history of Kawasaki disease have been catheterized for selective coronary arteriography. Their age at examination ranged from four months to 13 years. Coronary artery lesions (CAL) were found in 262 patients. As far as the type of the CAL was concerned, occlusion was ...

An unusual case of hemopericardium and presumed fatal cardiac tamponade complicating attempted right internal jugular vein catheterization by the posterior approach is reported. Reports of complications in a series of internal jugular vein catheterizations using various approaches (posterior, central, anterior, supraclavicular) and subclavian vein catheterizations are reviewed. Internal jugular vein ...

A case of mycotic thoracic pseudoaneurysm as a late complication of umbilical artery catheterization and septicaemia is presented. Thoracic pseudoaneurysm should be suspected when a child with mediastinal tumour has a history of neonatal umbilical artery catheterization complicated by septicaemia. The diagnosis should be established by CT-scanning, aortography or operation.

We report a case of silicone-induced endocarditis as a newly recognized complication of transvenous cardiac pacing catheterization. Silicone was found embedded in thrombotic vegetations on the tricuspid valve of a patient who had a long-standing pacing catheter in the right side of his heart. Scanning electron microscopy and energy-dispersive x-ray ...

Left heart catheterization via percutaneous entry of the brachial artery was attempted in 1,783 cases. A plain sheath without valve or side-port was employed and 7 and 8 French Sones catheters were used for females and males, respectively. Successful performance of the procedure was achieved in 96.5% of the cases. ...

This study was done to determine the accuracy and reliability of cardiac output measurements by the injection of indocyanine green into the left ventricle, with simultaneous sampling from a systemic artery. In 40 patients (18 men, 22 women, aged 34 to 74 years), cardiac output was measured in close temporal ...

A method is described combining percutaneous brachial catheterization techniques with the use of 5-French (F) preformed (Judkins) catheters. This method was used in 50 patients with one unsuccessful attempt to cannulate the brachial artery. There was one lost pulse requiring surgical thrombectomy but no other cardiac, vascular, or neurologic complications. ...

Since 1980, use of the transseptal approach to catheterization of the left side of the heart has increased at our institution. In our experience, the transseptal technique has been used most commonly in adult patients with aortic stenosis, in whom the ease of access and the more reliable hemodynamics make ...

Umbilical arterial catheterization caused major complications including 5 deaths in 25 of 230 infants who underwent autopsy at the Kandang Kerbau Hospital in a two-and-a-half year period beginning May 1982. Arterial thrombosis developed in 25 of 129 (19.3%) autopsies with a history of umbilical arterial catheterization. Pathological sequelae of thrombosis ...

To further define the clinical role of continuous wave Doppler echocardiography for determining aortic valve gradient, we studied 60 consecutive adult patients (age range 22 to 81 years, mean age 63) with suspected aortic stenosis within 24 hours of catheterization. Blind comparisons of Doppler peak and mean gradients by the ...

Urethral strictures that are impassable in retrograde fashion present a special problem to the urologist because they cannot be managed by standard dilatation techniques or direct-vision internal urethrotomy. Open urethroplasty is usually required. We describe a technique to catheterize the urethra in an antegrade fashion and dilate the strictures. Our ...

Although traditionally the exclusive domain of other medical specialties, pulmonary artery catheterization may be of tremendous benefit to a variety of obstetric and gynecologic patients. Our experience with such invasive hemodynamic monitoring in 72 patients in an obstetrics and gynecology service is presented. In 86% of cases, catheter placement and ...

Symptomatic pericardial effusion has been recognized as a diagnostic and therapeutic problem for many centuries. Although surgical incision and blind needle puncture of the pericardium for removal of the fluid have been available for somewhat more than 150 years, both procedures are associated with serious complications. Echocardiography provides a unique ...

Five infants with Pierre Robin syndrome developed evidence of carbon dioxide retention and congestive cardiac failure despite measures to alleviate upper airway obstruction. Investigations included chest radiography, electrocardiography, echocardiography, and cardiac catheterization; pulmonary hypertension was diagnosed. In two cases raised main pulmonary artery pressures of 40 mm Hg and 120 ...

Cardiac output was measured by two-dimensional echocardiographic Doppler technique in 55 adult patients in the intensive care unit. Doppler cardiac output determinations were measured from four sites (suprasternal long axis of the ascending aorta, suprasternal long axis of the descending aortic, apical left ventricular outflow tract, and parasternal long axis ...

The advantages and disadvantages of an arterial sheath to introduce catheters percutaneously through the femoral artery were prospectively studied in 184 consecutive patients without peripheral vascular disease undergoing routine diagnostic left heart catheterization and coronary arteriography. The arterial sheath was used randomly in 91 patients (sheath group) and the standard ...

A percutaneous method via the brachial artery for left heart catheterization and selective coronary angiography is described. The technique uses the sheath intended for the femoral artery, continuously infused and introduced following a particular technique. The procedure was performed with minimal complications over 18 months, with multipurpose "Schoonmaker" or preshaped ...

Arterial occlusions after cardiac catheterization are usually treated surgically. We report four patients with femoral thrombosis or distal emboli that developed after cardiac catheterization. Each patient was treated successfully with intravenous streptokinase. Therapy was initiated 1-60 hr after the procedure. The duration of infusion lasted 4-42 hr (mean 27 hr). ...

Two hundred fifty-three patients underwent cardiac catheterization with selective cineangiography of the carotid arteries. Diagnostic angiograms of both the right and left carotid arteries were obtained in 240 patients (95%). Of these, 217 patients (90%) were studied without complication, 18 (8%) had minor complications, and five (2%) had major complications. ...

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 ...

We report a case of pulmonary artery perforation with resultant cardiac tamponade after central venous catheterization and review six previously reported cases. Tamponade may be an acute or late complication and is usually associated with the effusion of intravenous fluid into the pericardium. Three cases actually occurred after catheterization through ...

Indications for hemodynamic assessment by right heart catheterization include shock, pulmonary edema, severe trauma and sepsis. The introduction of the catheter and the location of the tip in the pulmonary artery, however, can cause severe complications. In the present study the incidence of complications was observed in 93 consecutive right ...

Dependent edema, ascites, and exertional dyspnea developed in a patient seven months after pericardiectomy for constrictive pericarditis. Cardiac catheterization documented constrictive physiology. At the second operation, he was found to have extensive mediastinal fibrosis that encased the heart. Postmortem examination showed a fibrocartilagenous exoskeleton that encased both ventricles. Possible etiologies ...

From July 1977 to December 1982, 6,245 patients requiring cardiac and noncardiac operations had pulmonary artery (PA) catheterizations for perioperative monitoring. Their ages ranged from 4 to 94 years. PA catheters were inserted through the external or internal jugular vein in 6,146 patients, while arm veins were used in 99 ...

Inadvertent puncture of the intrapericardial aorta is a serious complication of transseptal catheterization. Two-dimensional echocardiography allows delineation and spatial resolution of the aorta and interatrial septum. Thirteen patients underwent transseptal catheterization with simultaneous monitoring of needle and catheter position using fluoroscopy and two-dimensional echocardiography. The interatrial septum was demonstrated in ...

Generalized arterial calcification in infancy is a rare disorder in which death usually occurs in infancy, the diagnosis generally being made at autopsy. Three patients are reported. The diagnosis was made during life in two, enabling new information to be collected. Cardiac catheterization in one provided evidence suggesting stiffness of ...