Catheterization and cardiovascular diagnosis
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Cathet Cardiovasc Diagn · May 1996
Case ReportsAortocaval fistula complicating abdominal aortic aneurysm: case report and literature review.
Aortocaval fistula is a rare complication of abdominal aortic aneurysm involving less than 1% of all abdominal aortic aneurysms. The diagnosis is difficult, and preoperative identification can be challenging. We describe an interesting case of a 72-year-old man presenting with acute-onset dyspnea who was found to have an aortocaval fistula secondary to a large abdominal aortic aneurysm. The clinical features that exemplify aortocaval fistula are discussed and the literature reviewed.
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Cathet Cardiovasc Diagn · Apr 1996
Core curriculum for the training of pediatric invasive/interventional cardiologists: report of the Society for Cardiac Angiography and Interventions Committee on Pediatric Cardiology Training Standards.
Within the field of pediatric cardiology, a number of subspecialty fields are generally recognized. Some of these overlap. For example, most electrophysiologists also would consider themselves to be clinical cardiologists. ⋯ The curricula is divided here into five major sections followed by a bibliography keyed to those sections. Also included is a suggested format for the objective evaluation and documentation of the progress of invasive pediatric cardiology fellows. It is intended to complement the core curriculum and provide a means for standardizing the evaluation of invasive pediatric cardiology fellows.
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Cathet Cardiovasc Diagn · Mar 1996
Subclavian vein anatomic subtypes defined by digital cinefluroscopic venography prior to permanent pacemaker lead insertion.
Digital cinefluoroscopic venography of the subclavian vein was performed in 26 consecutive patients. The optimal stored image of the anticipated venipuncture site was magnified, road mapped, and used to compare with fluoroscopic-guided venipuncture. Two anatomic subtypes for both subclavian veins were observed. ⋯ In three or 12% of patients venography showed either subclavian thrombosis or a persistent left superior vena cava and lead insertion was moved to the opposite side. Successful venipuncture and subsequent cannulation of the subclavian vein was achieved with the first or second passage of the needle in 22 or 85% of the 26 patients. Digital cinefluoroscopic venography appears to be both safe and rapid and may facilitate insertion of permanent pacemaker leads into the subclavian vein.
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Cathet Cardiovasc Diagn · Feb 1996
Case ReportsIdiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency.
A case of idiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency simulating a mediastinal teratoma occurred in an asymptomatic 13-year-old boy. The key to correct diagnosis was pulmonary angiography. The patient was successfully treated with surgery.
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Cathet Cardiovasc Diagn · Feb 1996
Activated clotting time differential is a superior method of monitoring anticoagulation following coronary angioplasty.
The standard high-range activated clotting time (sHR ACT) is used to monitor anticoagulation postangioplasty (PTCA), but may be unreliable. We assessed the accuracy of a new method we termed the ACT differential (ACT Diff), obtained by measuring the difference between an sHR ACT and a heparinase ACT from the same sample. Heparinase removes heparin from its sample and provides a current heparin-free baseline. ⋯ Incidence of major bleeding (0.2%), transfusion requirement (0.1%), false anneurysm (0.6%), and abrupt closure during heparin infusion (0.1%) remained low. In conclusion, the ACT Diff is more accurate than an sHR ACT, and its clinical use in PTCA patients is associated with a very low incidence of complications from anticoagulation. Its routine use should be considered by units unable to obtain rapid APTT results.