Pseudo Complications of Cardiac Catheterization (original) (raw)

Complications of cardiac catheterization in the current era: A single-center experience

Catheterization and Cardiovascular Interventions, 2001

Consecutive cardiac catheterization procedures done over a 2-yr period (April 1996 to March 1998) were prospectively analyzed to determine and characterize procedurerelated complications (in-hospital and 1-mo follow-up), as they occur at present. During the study period, 11,821 procedures (7,953 diagnostic and 3,868 therapeutic) were performed. The majority of procedures (> 60%) were done in high-risk patients. Stents were implanted in 33% of patients, and adjunctive abciximab was used in 6.6% of therapeutic procedures. The overall complication rate was 8% (3.6% of diagnostic procedures and 15.1% of therapeutic procedures). The procedure-related mortality rates were 0.2%, 0.1%, and 0.5% for total, diagnostic, and therapeutic procedures, respectively. Cardiac complications were seen in 3.9% (1.5% of diagnostic and 9% of therapeutic procedures). Emergency cardiac surgery was required in 0.05% of the diagnostic procedure group and 0.3% of the therapeutic procedure group (total, 0.1%). Despite marked changes in patient population and practice, the complication rates of cardiac catheterization remain very low. Cathet Cardiovasc Intervent 2001;52:289 -295.

Current complications of diagnostic and therapeutic cardiac catheterization

Journal of the American College of Cardiology, 1988

Data from 2,883 cardiac catheterizations performed during an 18 month period (from July 1986 through December 1987) were analyzed to assess the current complication profile of diagnostic and therapeutic procedures. Procedures performed during the study period included 1,609 diagnostic catheterizations, 933 percutaneous transluminal coronary angioplasties and 199 percutaneous balloon valvuloplasties. Overall, the mortality rate was 0.28% but ranged from 0.12% for diagnostic catheterizations to 0.3% for coronary angioplasty and 1.5% for balloon valvuloplasty. Emergency cardiac surgery was required in 12 angioplasty patients (1.2 %). Cardiac perforation occurred in seven patients (0.2%), of whom six were undergoing valvulo-From the Charles A.

Vascular complications of cardiac catheterization

The American Journal of Surgery, 1994

Femoral artery injury after diagnostic and therapeutic cardiac catheterization is a frequently encotmtered clinical problem. This study reviews 150 femoral artery injuries that occurred in 16,350 patients over a 5-year period. A prospective computerized cardiac catheterization data bank was used to determine significant risk factors associated with the occurrence of vascular injury. Logistic regression analysis revealed that congestive heart failure, female gender, and percutaneous transluminal coronary angioplasty or valvuloplasty procedure were significantly associated with occurrence of vascular injury. Greater age, smaller body surface area, and smaller weight were also associated with injury.

Outpatient cardiac catheterization: a report of 3,000 cases

Clinical cardiology, 1991

A total of 3000 patients have had cardiac catheterization in the Andreas Gruentzig Cardiovascular Laboratory of the Emory Clinic. The purpose of this presentation is 10 describe the patient population selected for this procedure and our experience with this group. The concept of catheterization as an outpatient is attractive from the standpoint of cost savings and time conservation. Safety has been questioned. We have found that this technique can be performed safely in carefully selected outpatients. Careful selection attempted to eliminate those with unstable symptoms, recent myocardial infarction, severe diabetes, and reniil failure. Small catheters were used to minimize the potential for bleeding. Excellent opacification of vessels was obtained with these catheters. Despite careful screening we found 2.2% had significant left main obstruction, 10.8% had triple-vessel disease, 16.0% had double-vessel disease, and 23.5% had single-vessel disease, and a similar percentage had normal coronary arteriograms. Our patients experienced ventricular fibrillation on five occasions, there were two small cerebral emboli with reversible neurologic defects, two episodes of pulmonary edema, and two episodes of severe allergic reactions. Only three palients had significant groin bleeding at home that required compression of the site. We subsequently did angioplasty on 323 patients, performed cardiac surgery (mostly coronary bypass) on 187 patients, and admitted 18.2% tvf the entire group. We conclude that this procedure can be done safely in this carefully designed setting and it saves time and offers cost savings. Patient selection is very important to minimize potential emergency situations and complications. The laboratory must be carefully set up

Evaluation of risk factors associated with femoral pseudoaneurysms after cardiac catheterization

Journal of Vascular Surgery, 2006

Background: Femoral pseudoaneurysm (FPA) is one of the common complications of percutaneous catheterization procedures performed via the femoral artery. The aim of this research was to evaluate factors associated with FPA of sufficient clinical significance that they required surgical treatment after diagnostic or interventional cardiac catheterization. Methods: We evaluated 41,322 transfemoral catheterization procedures performed in our center within 7 years. Among all procedures, 630 FPAs developed that required surgical repair. Eighty-five cases were managed by compression with duplex guidance. As a case-control group, 1260 patients were selected from the patients who had been catheterized during the same time period but did not develop FPA. Two controls were selected for each study patient, matched according to age, sex, and catheterization day. Body mass index, hypertension, diabetes mellitus, catheter diameter, coronary artery disease, atherosclerosis, and number of cases performed per day in a particular room were evaluated as risk factors by using multivariate techniques. Results: Femoral pseudoaneurysm required operative repair in 1.1% (n ‫؍‬ 398) of patients who underwent cardiac catheterization for diagnostic purposes and in 4.7% (n ‫؍‬ 232) of patients after cardiac interventional procedures. Factors found to be independently predictive of FPA were hypertension (P ‫؍‬ .011; odds ratio, 1.52), diabetes mellitus (P ‫؍‬ .035; odds ratio, 1.11), coronary artery disease (P ‫؍‬ .022; odds ratio, 1.21), larger (>28 kg/m 2 ) body mass index (P < .001; odds ratio, 2.21), larger number of cases (>18) performed per day in a particular room (P < .001; odds ratio, 2.39), and larger (>7F) catheter diameter (P < .001; odds ratio, 2.82). Conclusions: Due to the development of technology and experience, more and more diagnostic and interventional catheterization procedures are performed on a daily basis. In our study, a high volume of cases in a particular room and use of large catheters were important risk factors for FPA complications. When these situations are combined with other risk factors (such as obesity, diabetes mellitus, hypertension, and arteriosclerosis), giving particular attention to local compression therapy would be more crucial to decrease the FPA rate. ( J Vasc Surg 2006;43:520-4.)

Complications of pediatric cardiac catheterization: A 3-year study

Journal of the American College of Cardiology, 1992

Todeter:^^s the current risk ofpadiat ccardiaceathelerization, the complications and incidents of all catheterizations performed in a pediatric laboratory between January 1986 and October 1988 were prospectively recorded and compared wi results from a 1974 study from the same im:i. ition. In the current study 1 .037 catheterizations, 885 diagnostic and 152 diagnostielinleeventionat procedures, were performed in 888 patients (aged I Icy in 27, years, median 15.6 months). There were 15 major complications (1 .41-),70 minor complications (6.8%) and 30 incidents U.9%). Two patients died as a result of me procedure and two as a result of pericatheterization clinical deterioration caused by the cardiac abnormality. The great majority of complications were successfully treated or were self-limited and the 3atients had no residua. Of patients with 13 t)espite advances in the noninvasive evaluation of patients with congenital heart disease, cardiac catheterization continues to be essential for studying cardiac structure and hemodynamics but is associated with some risk. An earlier experience with complications of pediatric cardiac catheterization was reported from this laboratory in 1974 (1). Since that publication, changes in catheterization techniques, equipment, procedures, patient selection and peticarheterization medical management may have affected catheterization-related morbidity and mortality. This study was undertaken to determine the current risks of pediatric cardiac catheterization and to compare them with the results of the 1974 study from this institution. Factors considered significant in effecting changes in specific complications are discussed. Methods Study patients. Computerized records of diagnoses, hemodynaeoic data and complications for all patients undergo

Predictors of Vascular Complications Post Diagnostic Cardiac Catheterization and Percutaneous Coronary Interventions

Dimensions of Critical Care Nursing, 2006

Care of patients after cardiac catheterization and/or percutaneous coronary intervention is largely the responsibility of nurses. The identification of risk factors for vascular complications from these procedures is important for the development of protocols to prevent complications. This article describes a retrospective, descriptive, and correlational study of 11,119 patients who underwent cardiac catheterization and/or percutaneous intervention, with femoral artery access, in the years 2001 to 2003. Increased risk for vascular complications was found in patients who were older than 70 years, were female, had renal failure, underwent percutaneous intervention, and had a venous sheath.