The Journal of invasive cardiology
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Comparative Study
Cardiac cath lab activation by the emergency physician without prior consultation decreases door-to-balloon time.
The purpose of this before-and-after study is to determine whether an ED strategy which calls for cardiac catheterization lab (cath lab) activation directly by the emergency physician (EP) is effective in decreasing door-to-balloon time (DTBT). ⋯ We conclude that a strategy which mandates cath lab activation by the emergency physician for STEMI without prior cardiology consultation, reduces door to balloon time.
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Severe acute respiratory syndrome (SARS) is a highly contagious disease that has led to large hospital and community outbreaks, necessitating stringent infection control in its management. Among 90 SARS patients in our institution in the 2003 outbreak, 2 underwent cardiac catheterization. We report the personal respiratory protection and environmental control measures implemented to minimize the risk of droplets spread during these procedures, including re-engineering of the ventilation system of the cardiac catheterization laboratory (CCL). The report highlights the importance of collaboration of CCL personnel with relevant hospital engineering and management teams to develop a contingency infection control plan to prepare for future outbreaks of SARS or other epidemics.
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The aim of this prospective cohort study was to examine correlation between the postprocedural absolute rise of cardiac troponin (cTn-I), cardiac troponin T (cTn-T), and creatine phosphokinase MB (CK-MB), and predictive value of each marker for the long-term cardiac events following successful percutaneous coronary interventions. ⋯ Although the cTn-I is found to be relatively more sensitive cardiac marker, cTn-T can be used as an alternative assay with significant correlation, concordance, and prospective value. Both troponins have predictive value for long-term event free survival; particularly 4-fold increase is associated with worse event free survival.
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Percutaneous transcatheter closure of patent foramen ovale or atrial septal defect is an alternative to surgery for the treatment of platypnea-orthodeoxia syndrome. We report the hemodynamic characteristics and clinical and echocardiographic outcomes of 18 patients with platypnea-orthodeoxia syndrome that underwent transcatheter closure of patent foramen ovale or atrial septal defect. Successful closure was achieved in all patients with no in-hospital mortality or adverse events. Complete resolution of symptoms was seen in all patients and mean oxygen saturation increased from 82.6 +/- 5.4% to 96.1+/-2.2% post-procedure (p < 0.01).