Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Jan 2014
Case ReportsManagement of severe aortic regurgitation in a patient with cardiogenic shock using a percutaneous left ventricular assist device and transcatheter occlusion of the failed aortic valve homograft as a bridge to surgical valve replacement.
Acute hemodynamic compromise due to severe aortic regurgitation remains a difficult problem. The optimal management strategy and timing of surgery continues to evolve as new technologies become available. ⋯ We stabilized her condition by placing an Amplatz-type Atrial Septal Defect (ASD) occluder across her aortic valve in conjunction with a percutaneous left ventricular assist device as a bridge to surgical valve replacement. She went on to a successful surgery and recovered well.
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Catheter Cardiovasc Interv · Jan 2014
Case ReportsUnintentional embolization of a guide wire in the inferior vena cava during central venous catheter insertion successfully retrieved percutaneously 9 months later.
Central venous catheters are routinely positioned for hemodynamic monitoring and fluid administration in patients undergoing cardiac surgery, and many well-known complications associated with this manoeuver have been described. Metalic guide wire embolization is a rare complication potentially associated with nonmechanical and mechanical adverse events. The case we report is peculiar as an almost fully endothelialized guide wire was successfully retrieved 9 months after its unintentional embolization in the inferior vena cava.
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Catheter Cardiovasc Interv · Jan 2014
Case ReportsLeft main occlusion secondary to aortic root rupture following transcatheter aortic valve replacement managed by left main stenting.
Acute left main coronary occlusion secondary to a periaortic root hematoma secondary to annular rupture during transcatheter heart valve deployment is reported.
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Catheter Cardiovasc Interv · Jan 2014
Pediatric patient radiation dosage during endomyocardial biopsies and right heart catheterization using a standard "ALARA" radiation reduction protocol in the modern fluoroscopic era.
Surveillance endomyocardial biopsy (EMB) with right heart catheterization (RHC) is the standard of care for the assessment of post cardiac transplantation rejection. This procedure has traditionally relied upon fluoroscopy, which exposes both patient and staff to the risks of ionizing radiation. These risks may be of particular concern in the transplant patient who must undergo many such procedures lifelong. We present data on a new "ALARA - As Low As Reasonably Achievable" protocol to reduce radiation exposure during the performance of RHC with EMB. ⋯ The use of a novel ALARA protocol for RHC and EMB in pediatric cardiac transplantation patients markedly reduced radiation exposure to levels far below any previously reported values without negatively affecting the safety or efficacy of these procedures.
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Catheter Cardiovasc Interv · Jan 2014
Case ReportsA lumen sizing workhorse guidewire for peripheral vasculature: two functions in one device.
Ideally, guidewires used during peripheral vasculature (PV) interventions could serve both as a therapy delivery platform and a diagnostic tool for real-time vessel sizing (2-in-1 function). ⋯ Real-time, accurate, and safe PV dimension assessment and therapy-delivery (2-in-1 function) is possible using a novel workhorse 0.035″ bodied CGW.