Daily cardiac catheterization procedural volume and complications at an academic medical center

Slicker, Kipp; Lane, Wesley; Oyetayo, Ola O.; Copeland, Laurel A.; Stock, Eileen M.; Michel, Jeffrey B.; Erwin, John P.

doi:10.21037/cdt.2016.05.02

Cited by 23 publications

(10 citation statements)

References 23 publications

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“…Moreover, it has been suggested that rapid ventricular pacing may increase the risk of sustained ventricular arrhythmias compared to the baseline risk of cardiac catheterisation (less than 1%). 29 In our institutional series, three neonates (8%) developed ventricular fibrillation at the onset of rapid right ventricular pacing and were successfully defibrillated. Their procedures were completed with rapid right ventricular pacing at lower pacing rates by 20 bpm.…”

Section: Discussionmentioning

confidence: 88%

Rapid right ventricular pacing for balloon aortic valvuloplasty: expanding its routine use in neonates and infants

et al. 2020

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Objective: Rapid right ventricular pacing during balloon aortic valvuloplasty is commonly used to achieve balloon stability in children and adults. There is no consensus for the use of the technique in neonates and infants. We sought to review our institutional experience with rapid right ventricular pacing-assisted balloon aortic valvuloplasty across all age groups and evaluate the safety and effectiveness of the technique in the sub-group of neonates and infants <12months. Methods: Retrospective study between February, 2011 and February, 2020. Results: A total of 37 patients (Group I: 21 neonates/infants <12months and Group II: 16 children 12 months–16 years) were analysed. Catheter-measured left ventricular to aortic gradient reduced from median of 66 mmHg (with a range from 30 to 125 mmHg) to 14 mmHg (with a range from 5 to 44 mmHg) in Group I and 44 mmHg (with a range from 28 to 93 mmHg) to 18 mmHg (with a range from 2 to 65 mmHg) in Group II (p < 0.001). Procedure and fluoroscopy times were identical in the two groups. Balloon:annulus ratio was 0.94 and 0.88 in Groups I and II, respectively. Freedom from reintervention was 100% for Group I at a median time of 3.2 years and 81% at 2.7 years for Group II. Reinterventions in Group II (3/16 pts) were performed predominantly for complex left ventricular outflow tract stenosis. At follow-up echocardiogram, 45% of patients in Group I had no aortic regurgitation, 30% trace-mild, 20% mild-moderate, and 5% moderate aortic regurgitation, whereas in Group II, 50% of patients had no aortic regurgitation, 32% had mild aortic regurgitation, and 18% mild-moderate aortic regurgitation. Unicuspid valves were only encountered in Group 1 (2/21 pts, 10%) and they were predictive of mild-aortic regurgitation during follow-up (p = 0.003). Ventricular fibrillation occurred in three neonates with suspicion of myocardial ischemia on the pre-procedure echocardiogram. All were successfully defibrillated. Conclusions: Rapid right ventricular pacing can be expanded in neonates and infants to potentially decrease the incidence of aortic regurgitation and reintervention rates, hence avoiding high-risk surgical bail-out procedures for severe aortic regurgitation in the first year of life. Myocardial ischemia may predispose to ventricular dysrhythmias during rapid right ventricular pacing.

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Section: Discussionmentioning

confidence: 88%

Rapid right ventricular pacing for balloon aortic valvuloplasty: expanding its routine use in neonates and infants

et al. 2020

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“…Nonetheless, RRVP does have certain pitfalls, including a prolongation in operative time and a potentially higher risk of cardiac perforation and pneumothorax (if performed via the jugular/subclavian vein)[ 18 ]. It has also been suggested that rapid ventricular pacing may increase the risk of sustained ventricular arrhythmias compared to the baseline risk of cardiac catheterization (< 1%)[ 31 ]. According to our findings, only one (1.4%) case of ventricular fibrillation has been described, which was still successfully defibrillated[ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Rapid right ventricular pacing for balloon valvuloplasty in congenital aortic stenosis: A systematic review

Mylonas¹,

Ziogas²,

Mylona³

et al. 2020

WJC

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BACKGROUND Balloon aortic valvuloplasty (BAV) is a well-established treatment modality for congenital aortic valve stenosis. AIM To evaluate the role of rapid right ventricular pacing (RRVP) in balloon stabilization during BAV on aortic regurgitation (AR) in pediatric patients. METHODS A systematic review of the MEDLINE, Cochrane Library, and Scopus databases was conducted according to the PRISMA guidelines (end-of-search date: July 8, 2020). The National Heart, Lung, and Blood Institute and Newcastle-Ottawa scales was utilized for quality assessment. RESULTS Five studies reporting on 72 patients were included. The studies investigated the use of RRVP-assisted BAV in infants (> 1 mo) and older children, but not in neonates. Ten (13.9%) patients had a history of some type of aortic valve surgical or catheterization procedure. Before BAV, 58 (84.0%), 7 (10.1%), 4 (5.9%) patients had AR grade 0 (none), 1 (trivial), 2 (mild), respectively. After BAV, 34 (49.3%), 6 (8.7%), 26 (37.7%), 3 (4.3%), patients had AR grade 0, 1, 2, and 3 (moderate), respectively. No patient developed severe AR after RRVP. One (1.4%) developed ventricular fibrillation and was defibrillated successfully. No additional arrhythmias or complications occurred during RRVP. CONCLUSION RRVP can be safely used to achieve balloon stability during pediatric BAV, which could potentially decrease AR rates.

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“…This decline has been accompanied by an increase in PCI revascularization. Over 1,000,000 cardiac catheterizations are performed annually in US (45). Hence, significant improvements in the technology of coronary stents and vascular grafts is necessary to meet the clinical demand.…”

Section: New Options In Cardiac Revascularizationmentioning

confidence: 99%

Biomaterials and heart recovery: cardiac repair, regeneration and healing in the MCS era: a state of the “heart”

Franco¹,

Amarelli²,

Montalto³

et al. 2018

J. Thorac. Dis.

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Regenerative medicine is an emerging interdisciplinary field of scientific research that, supported by tissue engineering is, nowadays, a valuable and reliable solution dealing with the actual organs shortage and the unresolved limits of biological or prosthetic materials used in repair and replacement of diseased or damaged human tissues and organs. Due to the improvements in design and materials, and to the changing of clinical features of patients treated for valvular heart disease the distance between the ideal valve and the available prostheses has been shortened. We will then deal with the developing of new tools aiming at replacing or repair cardiac tissues that still represent an unmet clinical need for the surgeons and indeed for their patients. In the effort of improving treatment for the cardiovascular disease (CVD), scientists struggle with the lack of self-regenerative capacities of finally differentiated cardiovascular tissues. In this context, using several converging technological approaches, regenerative medicine moves beyond traditional transplantation and replacement therapies and can restore tissue impaired function. It may also play an essential role in surgery daily routine, leading to produce devices such as injectable hydrogels, cardiac patches, bioresorbable stents and vascular grafts made by increasingly sophisticated biomaterial scaffolds; tailored devices promptly fabricated according to surgeon necessity and patient anatomy and pathology will hopefully represent a daily activity in the next future. The employment of these devices, still far from the reproduction of functional organs, has the main aim to achieve a self-renewal process in damaged tissues simulating endogenous resident cell populations. In this field, the collaboration and cooperation between cardiothoracic surgeons and bioengineers appear necessary to modify these innovative devices employed in preclinical studies according to the surgeon's needs.

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Daily cardiac catheterization procedural volume and complications at an academic medical center

Cited by 23 publications

References 23 publications

Rapid right ventricular pacing for balloon aortic valvuloplasty: expanding its routine use in neonates and infants

Rapid right ventricular pacing for balloon aortic valvuloplasty: expanding its routine use in neonates and infants

Rapid right ventricular pacing for balloon valvuloplasty in congenital aortic stenosis: A systematic review

Biomaterials and heart recovery: cardiac repair, regeneration and healing in the MCS era: a state of the “heart”

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