By Gianfranco Butera, Massimo Chessa, Andreas Eicken, John Thomson
This guide is a perfect, updated consultant to the appliance of catheter-based interventions around the whole sufferer age diversity, from fetal lifestyles via to maturity. transparent guideline is accessible on thoughts of vascular entry, valve dilatation, angioplasty, stent implantation, illness closure, illness construction, pulmonary valve implantation and the hybrid process, in addition to miscellaneous different strategies. themes are approached utilizing a step by step structure, making sure that the reader will instantly be capable to entry info suitable to day-by-day perform. Many explanatory figures and drawings are integrated in each one bankruptcy in an effort to make clear extra the way to plan, practice and evaluation diagnostic and interventional approaches within the box of congenital middle ailment. cognizance is interested in vital assistance and tips that may help in reaching optimum results and an appendix contains extra common equations and BSA and oxygen intake charts.
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Additional info for Cardiac Catheterization for Congenital Heart Disease: From Fetal Life to Adulthood
Prolonged fluoroscopy during changes in angiographic projection is therefore avoided. ) with minimal trial and error or wasted fluoroscopy. 3 Use the Lowest Acceptable Frame Rate During Pulsed Fluoroscopy and Cine Angiography Always use pulsed fluoroscopy, never continuous fluoroscopy. , fast-moving vs. slow-moving; venous or arterial). 4 Do Not Use Fluoroscopy to Make Changes to the Patient/Table Position or Collimator/ Shields Patients should be moved first to the approximate desired location, and then fluoroscopy should be used very brief to check the position, followed by further adjustment.
They are monomers that dissolve in water but do not dissociate in solution. Hence, with fewer particles in solution, they are designated low-osmolar contrast media (LOCM). The most recent class of agents are dimers that consist of a molecule with two benzenes (again, each with 3 iodine atoms) that do not dissociate in water (nonionic). These compounds are called iso-osmolar contrast media (IOCM) (Fig. 1). The toxicity of CM decreases as osmolality approaches that of serum. HOCM have an osmolality of 1,570 mosm/kg H2O, while IOCM have an osmolality similar to serum at 290 mosm/ kg H2O.
16 Catheter Selection An end-hole catheter is useful for selective, relatively smallvolume injections by hand, such as into coronary arteries, aortopulmonary collaterals, and other small- or medium-sized arteries. Contrast injection into the cardiac chambers, main pulmonary trunk, or aorta should be made through a multi-sidehole catheter. Multiple side holes facilitate high contrast flow rates, high velocity of injection, and minimal catheter whip. 17 Contrast Delivery In general, for anatomic definition, contrast should be delivered through the catheter as rapidly as possible, generally in 1 or 2 s.