Cardiac Catheterization ; methods ; Heart Defects, Congenital ; therapy ; Humans

Cardiac Catheterization ; Catheterization ; methods ; Female ; Humans ; Lutembacher Syndrome ; diagnostic imaging ; therapy ; Middle Aged ; Ultrasonography

BACKGROUND: The diagnosis and estimation of severity of infundibular pulmonic stenosis (PS) is difficult by two-dimensional or M-mode echocardiography. In continuous wave(CW) Doppler signal valvular PS is seen as a parabolic velocity profile but infundibular PS is seen as a velocity signal with its peak in late systole. The purpose of this study is that Doppler echocardiography can discriminate valvular PS from infundibular PS and assess the severity of infundibular obstruction. METHOD: Six patients with valvular and infundibular PS by Doppler echocardiography and cardiac catheterization were studied. All had been undergone surgery. We compared their Doppler echocardiographic and cardiac catheterization finding with surgical finding. RESULT: 1) CW Doppler signal of infundibular PS had lesser peak velocity(2.84m/sec vs 4.33m/sec, p < 0.05) and later systolic peak in velocity(AT/ET ratio : 0.73 vs 0.51, p < 0.05) than that of valvular PS. 2) Pressure gradient across the infundibular obstruction measured by Doppler echocardiography correlated well with that by cardiac catheterization(r=0.89, p < 0.05). 3) Operation finding showed infundibular PS in 5 case but not one and coexisting other anomaly such as ASD in 4 case, TOF in 1 case, PAPVR in 1 case. CONCLUSION: Doppler echocardiography is a useful noninvasive method for the diagnosis and the estimation of severity of infundibular obstruction in patient with PS.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Humans ; Methods ; Pulmonary Valve Stenosis ; Systole

BACKGROUND: There have been few reports in the literature evaluating aortic valve area by multiplane transesophageal echocardiography(M-TEE) as well as Biplane TEE(B-TEE) in comparison with transthoracic echocardiography(TTE) and cardiac catheterization(CC) estimated aortic valve area. The pupose of this study was to evaluate assessment of aortic valve area in patients with aortic stenosis by M-TEE compared to B-TEE and TTE. METHOD: 145 patients with known aortic valve stenosis underwent TTE, CC and intraoperative TEE assessment of the aortic valve area. 81 were done with multiplane only, 64 were done with biplane only. Results were compared with valve areas determined invasively by Gorlin formula and noninvasively by TTE using simplified continuity equation, TEE using direct planimetry and TEE proximal stenotic jet width. Aortic valve areas were also compared in sugically confirmed bicuspid and tricuspid aortic valves seperately. RESULTS: The feasibility of TTE, M-TEE, B-TEE and JW were 95.2%, 100%, 87.5% and 95.9%, respectively. Correlation between valve areas determined by Gorlin equation and M-TEE was the highest(r=0.89, n=81). This was higher for bicuspid valves(r=0.93, n=32) than tricuspid aortic valves(r=0.87, n=48). Correlations between the area determined by the Gorlin equation and that determined by B-TEE(r=0.74, n=56) and TTE(r=0.66, n=138) were lower. Coreelation for bicuspid and tricuspid were also lower(r=0.77, n=23, and r=0.75, n=30, respectively in biplane assessment, and r=0.71, n=61, and r=0.65, n=73, respectively in TTE assessment). Correlation of invasively determined valve areas with JW was lowest(r=0.57, n=139) though bicuspid valve area correlated better(r=0.64, n=60)than tricuspid aortic valves(r=0.53, n=75). CONCLUSION: M-TEE is superior to B-TEE in the assessment of aortic valve stenosis. Bicuspid aortic valve areas were accurately measured more consistently than tricuspid aortic valve areas. M-TEE can be used addiotional method to evaluate aortic valve area with conventional TEE and cardiac catheterization.
Aortic Valve Stenosis ; Aortic Valve ; Bicuspid ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Humans ; Methods ; Mitral Valve

DSA was done in 133 examinations of 128 patients during 2 years consist of 9 examination of IV DSA and 124examination of selective cardiac DSA after cardiac catheterization. Open heart surgery was performed in 90patients and 12 patients showed discrepancy between pre-and post operative diagnosis, showing a total 86.7% ofdiagnostic accuracy with DSA. We experienced the significant reduction in dose of contrast media, 30-40% of doseof conventional cardiac heart disease. DSA is an accurate simple and safe method in evaluation of cardiac disases.
Angiography, Digital Subtraction ; Cardiac Catheterization ; Cardiac Catheters ; Contrast Media ; Diagnosis ; Heart Diseases ; Humans ; Methods ; Thoracic Surgery

The technique introduced in this paper is applied in the endocardial catheter operation, which describes the 3D heart model reconstruction before the operation for the endocardial navigation. After a series of CT images of the thorax are processed, an accurate 3D endocardial model can be reconstructed. At first, the series of 2D CT images are preprocessed for denoising and the enhancement,then they are constructed as the volume data. After the region growing segmentation in the 3D volume data according to the grey value of the voxel in the heart cavity, the heart surface rendering is got and the 3D model of endocardial cavity is reconstructed.
Cardiac Catheterization ; methods ; Imaging, Three-Dimensional ; Models, Cardiovascular ; Tomography, X-Ray Computed ; methods

OBJECTIVETo analyse the reasons for pacing lead abandonment during pacemaker replacement.

METHODClinical data of patients underwent permanent pacemaker replacement between Jan 1st, 1976 to Dec 31st 2006 in Fuwai Hospital were obtained and the reasons for pacing leads abandonment were analyzed.

RESULTSPacemaker was replaced in 1023 patients during this period and 235 pacing leads were abandoned, 131 leads (55.7%) were abandoned for leads malfunction, including leads body fracture (35, 14.9%), isolation defects (10, 4.3%), dislocations (10, 4.3%) and excessively high threshold values (76, 32.3%). Other reasons for leads abandonment were infection (50, 21.3%), incompatibility between the leads and new generator (30, 12.8%), need to degrade the pacing system (13, 5.5%) and other rare reasons (11, 4.7%).

CONCLUSIONThe most often reason for leads abandonment during pacemaker replacement is lead malfunction, including lead body fracture, isolation defect, dislocation and excessively high threshold value of the leads.

Cardiac Catheterization ; instrumentation ; methods ; Cardiac Pacing, Artificial ; methods ; Equipment Failure ; Equipment Safety ; Female ; Heart Failure ; therapy ; Humans ; Male ; Pacemaker, Artificial

Six cases of right external iliac and common femoral arterial thrombotic occlusions following transfemoral cardiac catheterization were found among the 117 infants and children with congenital heart disease. Physical findings of arterial thrombosis were lower extremity coldness and absence of femoral pulse, which appeared just after cardiac catheterization. Transcatheter local intrathrombotic infusion of Urokinase were done with 50000 IU bolus doses and 40000-50000 IU/h running doses. All 6 cases showed complete thrombolysis and re-establishment of femoral circulation. Three cases developed bleeding from arterial puncture sites, and were subsequently controlled properly by compression. No other complication was found. Our results suggest that local thrombolytic therapy with Urokinase is effective treatment method without significant complication for the infants and children with fresh thrombotic occlusions following cardiac catheterization and angiography.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Catheterization* ; Catheters* ; Child* ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant* ; Lower Extremity ; Methods ; Punctures ; Running ; Thrombolytic Therapy* ; Thrombosis ; Urokinase-Type Plasminogen Activator*

BACKGROUND: Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. METHODS: Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) referred for cardiac catheterization for preoperative assessment. Biplane cineangiography, conventional 2 dimensional echocardiography (2DE) and RT3DE were performed for the patients. A control group of 18 age and sex matched children was included and 2DE and RT3DE were performed for them. RESULTS: The mean LV end diastolic volume (LVEDV) and LVEDV index (LVEDVI) measured by RT3DE of patients were lower than controls (p value = 0.004, 0.01, respectively). There was strong correlation between the mean value of the LVEDV and the LVEDVI measured by RT3DE and angiography (r = 0.97, p < 0.001). The mean value of LV ejection fraction measured by RT3DE was lower than that assessed by 2DE (50 ± 6.2%, 65 ± 4.6%, respectively, p value < 0.001) in the studied TOF cases. There was good intra- and inter-observer reliability for all measurements. CONCLUSION: RT3DE is a noninvasive and feasible tool for measurement of LV volumes that strongly correlates with LV volumetry done by angiography in very young infants and children, and further studies needed.
Angiocardiography* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Cineangiography ; Echocardiography ; Echocardiography, Three-Dimensional* ; Humans ; Infant ; Methods ; Prospective Studies ; Tetralogy of Fallot*

OBJECTIVETo discuss the treatment of arrhythmia occurs in the process of transcatheter closure of perimembranous ventricular septal defects (VSD) in pediatric patients.

METHODS182 cases (mean age: 6.2 +/- 3.3 years) with membranous VSD underwent transcatheter occlusion procedure. Two different devices were used: the Amplatzer membranous VSD occluder in 81 patients and the domestic-made device in 101 patients. Electrocardiogram of all patients was recorded before and during closure and at one day after the procedure, and Holter monitoring was performed one week after the procedure.

RESULTSPerioperation arrhythmia occurred in thirty-one patients (17%). Second- or third-degree atrioventricular bundle (AVB) was noted during the procedure in four patients. Normal AV conduction recovered spontaneously before the catheters were withdrawn in three cases and another patient underwent surgical repair. In the other twenty-seven patients, arrhythmia was first documented between one day and one week after the procedure. Third-degree AVB was found in three (1.6%) children after the procedure and underwent the temporary pacemaker (TPM) was implanted, two of them recovered to normal sinus rhythm within one week, another patient underwent elective surgery to remove the occluder and repair the defect. Other arrhythmias were: left bundle-branch block (n = 3), right bundle-branch block (n = 12), second-degree AVB (n = 2), sinus tachycardia (n = 6).

CONCLUSIONSIn properly selected cases of perimembranous VSD, the transcatheter closure is safe and effective by using appropriate devices. During and after the procedure, closure of VSD can be associated with some kinds of arrhythmia, such as A-V block, more intensive observation and follow-up were therefore needed.

Adolescent ; Arrhythmias, Cardiac ; therapy ; Cardiac Catheterization ; adverse effects ; methods ; Child ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Male