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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Several congenital conditions can be treated via interventional cardiology procedures. Among these are atrial septal defect, patent ductus arteriosus and patent foramen ovale. Each of these is treated in a similar fashion, with the placement of an occluder through the foramen in question. This is then inflated mechanically and detached from the catheter that carried it into position. Fluoroscopy is initially in the PA position, with bespoke positioning to fit with the patient’s anatomy during the placement and deployment of the occluder.
Medical management of the cardiac patient undergoing coronary angiography
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
Sara Hungerford, Peter Ruchin, Gerard Carroll
Beyond interventional cardiology techniques for the coronary circulation, the field has also expanded to include interventions for structural heart disease. The term structural heart disease is used frequently to discuss a broad group of non-coronary heart disease, including congenital and acquired valvular heart disease. Structural heart disease interventions, such as transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve implantation (TMVI), represent a rapidly evolving branch of percutaneous treatments to correct lesions that were previously treated surgically, or simply not addressed.1
Applications in radiology
Published in Sam Beddar, Luc Beaulieu, Scintillation Dosimetry, 2018
Daniel E. Hyer, Ryan F. Fisher, Maxime Guillemette
Many of the same techniques previously discussed in the section on interventional cardiology are also utilized in interventional radiographic (IR) procedures to diagnose and treat areas of the body outside of the heart. The equipment used for these procedures is similar to that used in interventional cardiology, though the detectors are often larger in order to provide a wider field of view for imaging areas larger than the heart. IR procedures are commonly performed in the diagnosis and treatment of strokes, aneurysms, many forms of cancer, liver and kidney disease, and even spinal fractures. In all cases, fluoroscopy is used to guide instrumentation through the body in order to either diagnose or treat a particular disease.
COVID-19 pandemic and its impact on service provision: A cardiology prospect
Published in Acta Cardiologica, 2021
Sana Adam, Syeda Anum Zahra, Cheryl Yan Ting Chor, Yuti Khare, Amer Harky
The delay in patient presentation to hospital with conditions such as MI could be detrimental, possibly leading to out of hospital cardiac arrest. Analysis carried out in France highlighted that there was a 13% increase in out of hospital cardiac arrests [21]. A proportion of these cases can be attributed directly to infection with COVID-19, however, in patients who tested negative for COVID-19 the indirect effect of the virus such as heightened public anxiety, perceptions that hospitals are areas of high infection transmission and reorganisation of the healthcare system may have contributed to the increase in out of hospital cardiac arrests. A study conducted to evaluate the use of the handheld ECG in India found it to be valuable in monitoring heart disease remotely [22]. Such technology could be valuable for use with high-risk patients as it can allow for immediate examination and can help prevent patients going into cardiac arrest both in-hospital and out of hospital [23]. Currently, the literature on the long-term impact of delaying interventional cardiology procedures due to the pandemic is limited. Future studies could evaluate the long-term effects of delaying interventional cardiology procedures and could help identify strategies to decrease their impact on cardiovascular morbidity and mortality.
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
Long-standing native RVOT or conduit/bioprosthetic valve dysfunction has been recognized to be detrimental to right ventricular hemodynamics, and is associated with worse outcomes such as heart failure, arrhythmias, and death [1]. Surgical strategies for reconstruction of RVOT have evolved and include bioprosthetic valves and valved conduits with or without patch augmentation [2,3]. Long-term durability of these interventions, however is highly variable and repeated surgical interventions are typically required over a lifetime [4]. Considering this and the advent of transcatheter techniques, the principles of management have evolved, although there are certain limitations of existing transcatheter pulmonary valve technology. In this review, we aim to review the history of the evolution of the bioprosthetic pulmonary valves and the current clinical management of dysfunctional bioprosthetic pulmonary valves. An extensive review of the recent cardiac surgical/interventional cardiology literature was performed on PubMed and MEDLINE databases from 1958 to 2019 and portions of the article reflect our personal experiences as well.
How Will the Heart Team Evolve?
Published in Structural Heart, 2019
A more intriguing question is what the role is for surgeons in performing percutaneous transcatheter procedures. Cardiac surgeons are intelligent people, and clearly very dexterous. There is little question that, with the appropriate time and training, they can master interventional catheterization techniques. Already there are some institutions in which cardiac surgeons are pursuing additional training in cardiac catheterization, usually up to one year and typically devoted to structural heart disease. Of course, performing the procedure is only part of interventional cardiology. Physiology and the other cognitive aspects of cardiology should be mastered as well. While such training is likely due to an interest of surgeons to provide the full spectrum of services to valve patients, it is also probable that for some this training is seen as a hedge against the possible loss of surgical volume.