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JACC. Cardiovascular Imaging Dec 2014The left atrial appendage (LAA) is a finger-like extension originating from the main body of the left atrium. Atrial fibrillation (AF) is the most common clinically... (Review)
Review
The left atrial appendage (LAA) is a finger-like extension originating from the main body of the left atrium. Atrial fibrillation (AF) is the most common clinically important cardiac arrhythmia, occurring in approximately 0.4% to 1% of the general population and increasing with age to >8% in those >80 years of age. In the presence of AF thrombus, formation often occurs within the LAA because of reduced contractility and stasis; thus, attention should be given to the LAA when evaluating and assessing patients with AF to determine the risk for cardioembolic complications. It is clinically important to understand LAA anatomy and function. It is also critical to choose the optimal imaging techniques to identify or exclude LAA thrombi in the setting of AF, before cardioversion, and with current and emerging transcatheter therapies, which include mitral balloon valvuloplasty, pulmonary vein isolation, MitraClip (Abbott Laboratories, Abbott Park, Illinois) valve repair, and the implantation of LAA occlusion and exclusion devices. In this review, we present the current data regarding LAA anatomy, LAA function, and LAA imaging using the currently available noninvasive imaging modalities.
Topics: Animals; Atrial Appendage; Atrial Fibrillation; Cineangiography; Diagnostic Imaging; Echocardiography; Humans; Predictive Value of Tests; Risk Assessment; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 25496544
DOI: 10.1016/j.jcmg.2014.08.009 -
Korean Journal of Pediatrics Aug 2017During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in... (Review)
Review
During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.
PubMed: 29042864
DOI: 10.3345/kjp.2017.60.8.237 -
JACC. Cardiovascular Interventions May 2014
Topics: Aged, 80 and over; Aortic Valve Stenosis; Cardiac Catheterization; Cardiac Catheters; Cineangiography; Coronary Angiography; Coronary Vessels; Equipment Design; Female; Heart Injuries; Heart Valve Prosthesis Implantation; Heart Ventricles; Hematoma; Humans; Pericardial Effusion; Severity of Illness Index
PubMed: 24746658
DOI: 10.1016/j.jcin.2013.07.024 -
JACC. Cardiovascular Imaging Mar 2015Paravalvular regurgitation (PVR) is a frequent complication of transcatheter aortic valve replacement that has been shown to be associated with increased mortality. The... (Review)
Review
Paravalvular regurgitation (PVR) is a frequent complication of transcatheter aortic valve replacement that has been shown to be associated with increased mortality. The objective of this article is to review the most up-to-date information about the assessment and management of PVR and to propose a new more comprehensive and unifying scheme for grading PVR severity. A multimodality, multiparametric, integrative approach including Doppler echocardiography, cineangiography, hemodynamic assessment, and/or cardiac magnetic resonance is essential to accurately assess the severity of PVR and the underlying etiology. Corrective procedures such as balloon post-dilation, valve-in-valve, or leak closure may be considered, depending on the severity, location, and etiology of PVR.
Topics: Aortic Valve; Aortic Valve Insufficiency; Cardiac Catheterization; Cineangiography; Consensus; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Hemodynamics; Humans; Incidence; Magnetic Resonance Imaging; Multimodal Imaging; Predictive Value of Tests; Risk Factors; Severity of Illness Index; Treatment Outcome
PubMed: 25772838
DOI: 10.1016/j.jcmg.2015.01.008 -
JACC. Cardiovascular Interventions Dec 2008The field of pediatric cardiac interventions has witnessed a dramatic increase in the number and type of procedures performed. We review the most common procedures... (Review)
Review
The field of pediatric cardiac interventions has witnessed a dramatic increase in the number and type of procedures performed. We review the most common procedures performed in the catheter laboratory. Lesions are divided according to their physiological characteristics into left-to-right shunting lesions (atrial septal defect, patent ductus arteriosus, ventricular septal defect), right-to-left shunting lesions (pulmonary stenosis, pulmonary atresia/intact ventricular septum), right heart obstructive lesions (peripheral arterial pulmonic stenosis, right ventricular outflow tract obstruction), and left heart obstructive lesions (aortic valve stenosis, coarctation of the aorta). In addition, a miscellaneous group of lesions is discussed.
Topics: Cardiac Catheterization; Child; Child, Preschool; Cineangiography; Coronary Angiography; Coronary Circulation; Echocardiography, Doppler, Color; Equipment Design; Female; Heart Defects, Congenital; Hemodynamics; Humans; Infant; Infant, Newborn; Male; Radiography, Interventional; Treatment Outcome; Ultrasonography, Interventional
PubMed: 19463373
DOI: 10.1016/j.jcin.2008.07.007 -
Einstein (Sao Paulo, Brazil) 2015Non-ST segment elevation coronary syndrome usually results from instability of an atherosclerotic plaque, with subsequent activation of platelets and several coagulation... (Review)
Review
Non-ST segment elevation coronary syndrome usually results from instability of an atherosclerotic plaque, with subsequent activation of platelets and several coagulation factors. Its treatment aims to reduce the ischemic pain, limiting myocardial damage and decreasing mortality. Several antiplatelet and anticoagulation agents have been proven useful, and new drugs have been added to the therapeutic armamentarium in the search for higher anti-ischemic efficacy and lower bleeding rates. Despite the advances, the mortality, infarction and readmission rates remain high.
Topics: Acute Coronary Syndrome; Angina, Unstable; Anticoagulants; Cineangiography; Critical Care; Evidence-Based Medicine; Humans; Myocardial Infarction; Platelet Aggregation Inhibitors
PubMed: 26466065
DOI: 10.1590/S1679-45082015RW3172 -
Archives of Disease in Childhood Feb 1973
Topics: Cardiomegaly; Cineangiography; Female; Heart Defects, Congenital; Heart Ventricles; Humans; Infant
PubMed: 4266122
DOI: 10.1136/adc.48.2.160-a -
Clinical Cardiology Feb 1991The occurrence and influence of coronary collateral circulation and obstruction of the supplying coronary arteries on left ventricular contractility, prevalence of...
The occurrence and influence of coronary collateral circulation and obstruction of the supplying coronary arteries on left ventricular contractility, prevalence of myocardial infarction, and bicycle exercise ergometer test were studied in a random sample of 286 patients with angiographically documented coronary artery disease. Collaterals appeared increasingly in all three main coronary arteries with grade of obstruction. The highest prevalence of collaterals occurred in stenosis of the right coronary artery (60%), followed by the left descending artery (45%); they occurred least in the left circumflex artery (21%) (p less than 0.001). The frequency of intra-arterial collateral circulation was 42%, 11%, and 12%, respectively (p less than 0.001). With total occlusion of the left anterior descending coronary artery, 22% of the patients had normokinetic anterior and apical left ventricular wall when collaterals were present. More often, the inferior wall showed normal contraction with total occlusion of the right coronary artery and collaterals [52%, p less than 0.001 compared with left anterior descending artery (LAD)]. The prevalence of inferior myocardial infarction was 39%, with collateral circulation to the totally occluded right coronary artery. The respective prevalence of anterior infarction and total occlusion in the left coronary artery was 58% (p less than 0.02). The presence or absence of collaterals had no obvious influence on ST-segment response during bicycle ergometer test. In triple-vessel disease, peak work capacity was better when collaterals to LAD were not jeopardized (427 kpm) than when jeopardized (321 kpm) (p less than 0.02).
Topics: Analysis of Variance; Cineangiography; Collateral Circulation; Coronary Circulation; Coronary Disease; Coronary Vessels; Electrocardiography; Exercise Test; Female; Humans; Male; Middle Aged; Myocardial Contraction; Myocardial Infarction; Ventricular Function, Left
PubMed: 2044240
DOI: 10.1002/clc.4960140206 -
Clinical Cardiology Jan 1991Angiographic imaging suffers from many limitations which may distort the diagnostic information obtained from coronary arteriograms. Radiographic features limiting... (Review)
Review
Angiographic imaging suffers from many limitations which may distort the diagnostic information obtained from coronary arteriograms. Radiographic features limiting precise coronary stenosis measurement are caused by the x-ray source, the image intensifier, and the chemical properties of the cinefilm. Biologic variations are introduced by fluctuations in angiographic contrast concentration and flow- or contrast-dependent coronary dilation. Random errors are also introduced by the selection of the radiographic projection and frame to be analyzed and the digitization of cineangiograms. These limitations and their significance in distorting quantitative information obtained from coronary angiograms are discussed in this review.
Topics: Angiography; Cineangiography; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; Humans
PubMed: 2019026
DOI: 10.1002/clc.4960140106 -
Open Heart 2019
Review
PubMed: 31168390
DOI: 10.1136/openhrt-2019-001034