Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Feb 2010
Case ReportsRetrieval of an embolized amplatzer septal occluder.
Percutaneous closure of secundum atrial septal defect (ASD) by various devices has been proven to be an effective and safe treatment modality for patients with congenital heart diseases. However, we have to be aware of the potential early and late complications like device embolization and formulate plan for rescue procedures. We have reported a case of successful closure of a large secundum ASD in a 23-year-old woman by a 40 mm Amplatzer septal occluder (ASO), which embolized into the right ventricle 4 hr after the procedure. ⋯ This would prevent the device from obstructing the inflow and outflow tract and causing catastrophic consequences. Then, a 15-mm Amplatz gooseneck snare was used to catch exactly at the connecting hub of the ASO disk, and the whole apparatus could then be cautiously and safely retrieved out from her body without complications. This had saved her from an unplanned emergency open heart operation that carried significant bleeding complication.
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Catheter Cardiovasc Interv · Feb 2010
A further word of caution before using the internal mammary artery for coronary revascularization in patients with severe peripheral vascular disease!
To characterize the clinical and angiographic characteristics of patients with collateralization from the internal mammary artery to the iliac artery. ⋯ Selective angiographic visualization of the internal mammary artery is an essential part of the preoperative evaluation in patients with severe peripheral vascular disease undergoing CABG.
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Catheter Cardiovasc Interv · Feb 2010
Multicenter StudyImpact of the prehospital ECG on door-to-balloon time in ST elevation myocardial infarction.
National guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomes for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times. ⋯ Utilizing the prehospital ECG as a tool to bypass ER triage significantly decreases D2B times in patients with STEMI. This technology has the potential to substantially expedite reperfusion therapy in patients with STEMI.
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Catheter Cardiovasc Interv · Feb 2010
A comparison of the VASP index between patients with hemodynamically complicated and uncomplicated acute myocardial infarction.
Critically-ill patients with ST-segment elevation myocardial infarction (STEMI) often present with insufficient gastroduodenal motility, liver hypoperfusion, and higher levels of circulating catecholamines. All of these factors can lead to reduced efficacy of clopidogrel, which is only available as a p.o. medication. The aim of the study was to compare clopidogrel effectiveness in unstable STEMI patients on mechanical ventilation with stable STEMI patients. ⋯ Laboratory clopidogrel efficacy is lower in patients with MI and severe hemodynamic instability, probably due to splanchnic and liver hypoperfusion and catecholamine use.