Safety and Hemodynamic Effects of Pulmonary Angiography in Patients with Pulmonary Hypertension: 10-Year Single-Center Experience

Hofmann, Lawrence V.; Lee, David S.; Gupta, Ajay; Arepally, Aravind; Sood, Sahil; Girgis, Reda E.; Eng, John

doi:10.2214/ajr.183.3.1830779

Cited by 35 publications

(21 citation statements)

References 32 publications

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“…These numbers were lower than expected because patients with pulmonary hypertension are a high-risk population, and fatal complications of invasive procedures have been repeatedly reported in these patients (11)(12)(13)21,26,27). Earlier series from the 1980s and 1990s reported much higher complication rates.…”

Section: Discussionmentioning

confidence: 84%

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Complications of Right Heart Catheterization Procedures in Patients With Pulmonary Hypertension in Experienced Centers

Hoeper

Lee

Voswinckel

et al. 2006

Journal of the American College of Cardiology

522

313

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Section: Discussionmentioning

confidence: 84%

“…A series of 402 patients with pulmonary hypertension reported no procedure-related mortality (25). In contrast, a more recent survey of 202 pulmonary angiographies performed in patients with pulmonary hypertension reported three procedure-related fatal complications (26).…”

mentioning

confidence: 99%

Complications of Right Heart Catheterization Procedures in Patients With Pulmonary Hypertension in Experienced Centers

Hoeper

Lee

Voswinckel

et al. 2006

Journal of the American College of Cardiology

522

313

View full text Add to dashboard Cite

show abstract

“…1,5,7,8 However, in a population as fragile as PAH patients, there is often hesitance to perform invasive procedures such as catheterization, especially when it includes the use of GA. Much of this hesitation comes from anecdotal reporting and higher rates of mortality and serious complications from older series in the 1980s, 17,18 as there is very little recent literature regarding the risks and complication rates of catheterization in PAH patients. Hofmann et al 11 reported their 10-year single-center experience performing pulmonary angiography in 202 mostly adult patients with PAH in 2004 and found an overall complication rate of 2.0%, although all complications were major and 3 were fatal. In 2007, Taylor et al 12 reported their 5-year single-center experience performing catheterization under GA in 70 pediatric patients, finding an overall complication rate of 8.6%, a major complication rate of 5.7%, and 1 fatal outcome (1.4%).…”

Section: Discussionmentioning

confidence: 99%

Safety of Cardiac Catheterization at a Center Specializing in the Care of Patients with Pulmonary Arterial Hypertension

et al. 2013

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Cardiac catheterization is important for the management of patients with pulmonary arterial hypertension (PAH). It is used for diagnosis, assessment, and monitoring of PAH patients, as well as to perform interventions such as balloon atrial septostomy and coil embolization of collateral vessels. Although reports on the risks of catheterization in PAH patients are scarce, many centers hesitate to perform these procedures in such fragile patients. We performed a retrospective chart review of all cardiac catheterizations performed in PAH patients over 10 years at our pulmonary hypertension center. Demographic, hemodynamic, and outcome data were collected. Complication rates were determined, and multivariate proportional hazards modeling was performed to identify predictors of catheterization-related complications. There were 1,637 catheterizations performed in 607 patients over 10 years. Pediatric patients accounted for 50% of these cases, 48% were performed in patients with idiopathic PAH, and 49% were performed under general anesthesia. While the overall complication rate was 5.7%, the rate of major complications was only 1.2% (n = 20). Although there were 8 deaths during the admission following catheterization, only 4 of these were related to the procedure, yielding a catheterization-related mortality of 0.2%. In conclusion, when performed at a pulmonary hypertension center with expertise in the care of PAH patients, cardiac catheterization is associated with low complication rates and mortality, and it should remain an important tool in the management of these patients.

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“…[48] With the availability of new contrast agents and the use of selected views only, the pulmonary angiography has been shown to be safe in PH. [49] Pulmonary angiography can be part of the RHC but should be performed after all hemodynamic assessments have been performed.…”

Section: Clinical Approach To Pulmonary Hypertensionmentioning

confidence: 99%

Saudi guidelines on the diagnosis and treatment of pulmonary hypertension: 2014 updates

Idrees¹,

Saleemi²,

Azem³

et al. 2014

Ann Thorac Med

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The Saudi Association for Pulmonary Hypertension (previously called Saudi Advisory Group for Pulmonary Hypertension) has published the first Saudi Guidelines on Diagnosis and Treatment of Pulmonary Arterial Hypertension back in 2008.[1] That guideline was very detailed and extensive and reviewed most aspects of pulmonary hypertension (PH). One of the disadvantages of such detailed guidelines is the difficulty that some of the readers who just want to get a quick guidance or looking for a specific piece of information might face.All efforts were made to develop this guideline in an easy-to-read form, making it very handy and helpful to clinicians dealing with PH patients to select the best management strategies for the typical patient suffering from a specific condition. This Guideline was designed to provide recommendations for problems frequently encountered by practicing clinicians involved in management of PH. This publication targets mainly adult and pediatric PH-treating physicians, but can also be used by other physicians interested in PH.

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Safety and Hemodynamic Effects of Pulmonary Angiography in Patients with Pulmonary Hypertension: 10-Year Single-Center Experience

Abstract: The complication rate of pulmonary angiography in patients with pulmonary hypertension is low. However, in severely ill patients with acute pulmonary hypertension, pulmonary angiography should be undertaken with extreme caution.

Cited by 35 publications

References 32 publications

Complications of Right Heart Catheterization Procedures in Patients With Pulmonary Hypertension in Experienced Centers

Complications of Right Heart Catheterization Procedures in Patients With Pulmonary Hypertension in Experienced Centers

Safety of Cardiac Catheterization at a Center Specializing in the Care of Patients with Pulmonary Arterial Hypertension

Saudi guidelines on the diagnosis and treatment of pulmonary hypertension: 2014 updates

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