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Transfemoral Transcatheter Aortic Valve Implantation
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Several methods can be used to assess PVR. The most frequently used modality is echocardiography which can identify, localize and grade the severity of PVR. Cineangiography can also be done but is highly subjective and has wide inter-observer variability. Other methods include hemodynamic measurement. An objective measurement of PVR severity called the aortic regurgitation index was proposed by Sinning et al. This is a simple, reproducible method to assess AR, calculated by the following formula: [(DBP – LVEDP)/SBP] ×100 (DBP = diastolic blood pressure, LVEDP = left ventricular end diastolic pressure, SBP = systolic blood pressure) [17] (Figure 8.2.25).
Introduction to the Endovascular Suite and Basic Principles of Angiography
Published in Vikram S. Kashyap, Matthew Janko, Justin A. Smith, Endovascular Tools & Techniques Made Easy, 2020
Jason Ty Turner, Virginia L. Wong
Prolonged pedal activation will capture and display multiple images using pulse dose fluoroscopy, with a frame (image capture) rate that is adjustable. A slower frame rate, such as 2–3 frames/second, is selected when using fluoroscopy to aid navigation of wires, catheters, and other devices. Imaging rapid movements or changes in position requires a higher frame rate. Cineangiography, or a cine run, is a series of successive X-ray images typically obtained at 15–30 frames/second and is used to capture the movement of radiopaque contrast injected into vessels.
The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Angiography employs a contrast medium injected into arteries, veins, or heart chambers to define anatomy, disease, or blood flow on a series of roentgenograms. Depending on the placement of the needle or catheter through which the dye is injected and the volume and rate of injection, angiograms can opacify chambers to detect cardiomegaly and space-occupying tumors, define valvular functioning to determine competence, demonstrate flow characteristics in vessels to allow diagnosis of aneurysms, atherosclerotic narrowing, infarctions, or numerous other disorders. Most angiograms include X rays taken six times per second, but the images are not visible as they are made since the film must be processed. Image intensification and amplification fluoroscopy, however, have made cineangiography (moving pictures of vessels) possible. Although resolution is lower than with still films, the motion better depicts many cardiac events.
A quality project for radiation reduction in the cath lab
Published in Acta Cardiologica, 2019
Michel de Ceuninck, Philip Muyldermans, Stefaan van de Walle, Bernard Bergez, Rik Haspeslagh, Francis Stammen, Karl Dujardin
Hence, obtained measurements are thus classified:Patient measurements:The DAP radiation measurements are obtained for all patients that underwent a left heart cardiac catheterisation/coronarography (or coronary cineangiography), whether or not followed by angioplasty (or PCI), during the three different periods of 8 weeks.For period 2 and 3, a dosimeter is positioned at 20 cm above the centre point between the two knees of the patient. This dosimeter measures the radiation load of the patient. In period 3, the dosimeter lies beneath the lead pelvic shield that covers the patient.Operator measurements:The dosimeter measurements under the lead apron and above it are registered for the three consecutive periods.One operator wears an additional Tracerco dosimeter beneath his apron. These measurements are to be compared with these from the thermoluminescent dosimeter worn under the apron (mentioned above, 1(a)) for the three periods.
Interventional therapies for relief of obstruction in hypertrophic cardiomyopathy: discussion and proposed clinical algorithm
Published in Hospital Practice, 2018
Srihari S Naidu, Jason Jacobson, Sei Iwai, Tanya Dutta, Wilbert S Aronow, Angelica Poniros, Ramin Malekan, David Spielvogel, Julio A Panza
Based on expert opinion, the amount of ethanol can be estimated based on the septal thickness at the point of SAM. Thus, if the septum is 2.0 cm thick then no more than 2 cc of ethanol should be used, in general. Ethanol is infused at a rate of 1 cc/min, with echo images toggling between parasternal long and then apical 3. As ethanol infuses, the parasternal view will be increasingly shadowed, making the apical 3 chamber view the ideal view for extent of basal septal opacification. The 2 and 4 chambers can be toggled quickly to confirm normal wall motion of all other walls, making fluoroscopy less important in the modern era. This is important as the sonographer’s hand is usually in the path of radiation, and thus minimizing fluoroscopy or cineangiography is important, especially at high volume centers.
Current clinical management of dysfunctional bioprosthetic pulmonary valves
Published in Expert Review of Cardiovascular Therapy, 2020
Varun Aggarwal, Zachary A Spigel, Gurumurthy Hiremath, Ziyad Binsalamah, Athar M Qureshi
Transcatheter therapy for dysfunctional pulmonary bioprosthetic pulmonary valve is performed in the cardiac catheterization laboratory, with the use of biplane fluoroscopy and cineangiography whenever available. Depending on the size of the patient, and access trajectory, these procedures are performed from the femoral vein or internal jugular vein. Alternative routes of access or if needed, hybrid delivery (in conjunction with surgical techniques) can also be performed if needed due to small patient size, limitations in access or better trajectory.