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Cardiac Imaging
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A means of evaluating the myocardium, valves and coronary vessels for valve or myocardial damage, anatomical defects or vessel occlusions. The following technologies are used in cardiac imaging:- Coronary Angiography: Performed in the catheterization lab, coronary angiography provides X-ray images of the heart and coronary vessels by inserting a catheter into the coronary vasculature via the groin, arm or neck. Contrast dye is injected via the catheter to visualize the heart and coronary arteries to provide information on cardiac function, congenital defects, and stenoses in the arteries.
- Ultrasound Imaging (Echocardiography): Sound waves examine the structure and functioning of the heart and valves. Echocardiographic technologies include Doppler, 3-D, stress echocardiography, transesophageal echocardiography (used during cardiac surgery).
- Nuclear Imaging: A cardiac function and perfusion diagnostic technology that uses radioactive compounds administered intravenously and images the heart and vessels with a gamma camera to provide information on the heart’s structure and function. Types of nuclear imaging include multigated acquisition scan (MUGA), positron emission tomography (PET) and sestamibi-exercise stress testing.
- Cardiac Magnetic Resonance Imaging (CMR): A specialized cardiac MRI scanner uses radiofrequency waves and a strong magnetic field to noninvasively image the heart and coronary vessels; contrast media is sometimes used. CMR provides very clear, detailed images and is increasingly considered the best diagnostic tool to evaluate heart disease, structure, size and function.
- Cardiac Computed Tomography (or CT Angiography): A CT scanning machine provides a noninvasive means of evaluating the myocardium, coronary arteries, pulmonary veins, thoracic aorta, pericardium and cardiac masses.
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Catheter-Induced Coronary Artery Dissection: Risk Factors, Prevention and Management
ABSTRACT: Guide catheter-induced dissection of the coronary arteries is an uncommon but potentially catastrophic complication of diagnostic and interventional cardiac catheterization. Several factors placing the individual at higher risk of this complication have been identified. We discuss these risk factors and utilize them to propose methods to prevent dissections. Management options of coronary artery dissection are also discussed.
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A Practical Approach to Endovascular Therapy for Infrapopliteal Disease and the Treatment of Critical Leg Ischemia: Savage or Salvage Angioplasty?
Critical limb ischemia is frequently associated with significant peripheral vascular disease (PVD) below the knee. Cardiologists historically have ignored this area of intervention, relegating its management to vascular surgeons. In this article, we will savage the misconceptions regarding the endoluminal treatment of claudication and limb salvage as it relates to tibial-peroneal disease. Anatomy, imaging, access techniques, as well as the results of a decade?s experience with the technique will be explored, with the view of promoting a role for interventional cardiologists in the treatment of limb salvage.
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Global Akinesis: Inadvertent Left Ventricular ?Pseudoaneurysmogram?
ABSTRACT: With today's widespread use of thrombolytic therapy and primary coronary intervention, left ventricular (LV) pseudoaneurysms (PA) are now uncommon sequela of myocardial infarction. Nonetheless, when encountered, the decision of surgical versus medical therapy is not always clear. We present a patient who developed a massive postinfarct PA, likely due to refusal of therapy. The LV was initially believed to be globally akinetic on catheterization. Subsequent review revealed, however, that the left ventriculogram was, in reality, a ?psuedoaneurysmogram?. The recommendation for surgical intervention in this patient was prompted by the need for coronary bypass as well as mitral valve repair.
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Is Routine Functional Testing Åfter Coronary Bypass Surgery Worthwhile?
Is Routine Functional Testing Åfter Coronary Bypass Surgery Worthwhile? Lack of benefit for routine functional testing early after coronary artery bypass graft surgery: Results from the ROSETTA-CABG Registry. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration.
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January 2006
This issue also includes a Rapid Communication submission. In the Clinical Images special section, Drs. This issue also includes excellent case reports that can be found online.
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Improvement in Left Ventricular Function following Successful Rescue Percutaneous Coronary Intervention Is Independent of Time-to-Reperfusion
Objective. To study the influence of clinical and angiographic factors on global and regional left ventricular (LV) function after rescue percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI). Methods. We performed repeat cardiac catheterization in 102 patients who underwent rescue PCI at our centre. Eighty-two patients had suitable baseline and follow-up ventriculograms, which were analyzed offline by an automated edge detection technique. Results. The mean (standard deviation [SD]) follow-up period was 22 (15) months. PCI was completed in all patients between 3 to 24 hours following the onset of pain. Improved global and regional LV systolic function was observed in 55 (67%) patients, and deterioration in 27 (33%). On univariate analysis, baseline ejection fraction (p = 0.005) and coronary stenting (p = 0.05) were associated with improved LV systolic function. Preprocedure TIMI flow, postprocedure TMP grade, time-to-reperfusion, and use of glycoprotein (GP) IIb/IIIa inhibitors did not influence LV systolic function. On multivariate analysis, ejection fraction at the time of rescue PCI (odds ratio [95% confidence interval]: 0.427 [0.234, 0.780]; p = 0.006) and stenting 3.944 (1.182, 13.156; p = 0.026) were predictors of improved LV systolic function. Conclusion. Successful rescue PCI was associated with improved LV function at follow up in the majority of patients. Stenting, but not GP IIb/IIIa inhibitor therapy, predicted improved LV function in the area supplied by the infarct-related artery. These improvements in regional wall motion were independent of the time taken to establish reperfusion, provided the intervention was carried out between 3 to 24 hours from the onset of pain. J INVASIVE CARDIOL 2006;18:330?333
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Real-Time, Three-Dimensional Localization of a Brockenbrough Needle during Transseptal Catheterization Using a Nonfluoroscopic Mapping System
We describe a new technique that allows real-time, three-dimensional (3-D) localization of the Brockenbrough needle tip during transseptal catheterization using the EnSite NavX? system. Transseptal catheterization has been traditionally performed using fluoroscopy, and recently, with the use of intracardiac echocardiography. However, even intracardiac echocardiography has the limitation of providing only 2-D views limited to the ultrasound plane. By displaying the transseptal needle on the EnSite NavX system, we achieved real-time 3-D localization of the needle tip within the right atrial geometry and found accurate visual correlation between fluoroscopy, intracardiac echocardiography and nonfluoroscopic 3-D cardiac mapping. This study suggests that the EnSite NavX system is able to provide 3-D localization of the transseptal needle during transseptal catheterization, and may be a useful imaging modality in this procedure. J INVASIVE CARDIOL 2006;18:324?327
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Validation of 4 French Catheters for Quantitative Coronary Analysis: In Vivo Variability Assessment Using 6 French Guiding Catheters as Reference Scaling Devices
Validation of 4 French Catheters for Quantitative Coronary Analysis: In Vivo Variability Assessment Using 6 French Guiding Catheters as Reference Scaling Devices ORIGINAL ARTICLES: Validation of 4 French Catheters for Quantitative Coronary Analysis: In Vivo Variability Assessment Using 6 French Guiding Catheters as Reference Scaling Devices - Marcelo Sanmartin, PhD, Javier Goicolea, MD, Raul Castellanos, MD, Marisol Bravo, MD, Raymundo Ocaranza, MD, Diogenes Cuevas, MD, Ramon Mantilla, MD, ...
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Noninvasive Assessment of Coronary Artery Bypass Graft Patency and Flow Characteristics by Electron-Beam Tomography
ABSTRACT: Objective. To evaluate the flow characteristics and accuracy for the detection of patent or occluded coronary artery bypass grafts (CABG) with multi-slice flow study of electron-beam tomography (EBT). Methods. One hundred and twenty-three patients who had undergone CABG surgery were enrolled in this study. Flow datasets were assessed with time-density curves by EBT. The EBT results were blindly compared with post-operative cardiac catheterizations in 26 patients. Results. Image quality was adequate to evaluate in 111 patients (90.2%). Flow curves of bypass grafts were technically adequate in 265 of 309 (85.8%) saphenous-vein grafts (SVG) and 35 of 56 (62.5%) internal mammary artery (IMA) grafts (p < 0.05). In comparison to conventional angiographic results, EBT correctly identified 14 of 16 occluded grafts (sensitivity, 87.5%) and 68 of 75 patent grafts (specificity, 90.7%), yielding an accuracy of 90.1%. The intra-graft flows of the IMA and SVG were 4.9 ± 2.2 ml/min/g and 6.9 ± 2.8 ml/min/g, respectively (p < 0.001), which was 31.6 ± 20.4% and 39.4 ± 21.9% of the ascending aorta?s flow (16.7 ± 5.0 ml/min/g) (p < 0.001). Conclusion. EBT flow study can be used in the assessment of CABG patency and quantification of intra-graft flow of patent CABG vessels.
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 Electrophysiologic Perspective on the BIPOLAR RF EPICARDIAL ABLATION Procedure for Atrial Fibrillation
Complimentary Accredited Breakfast Symposium
Click Here for More Info.
Location: The St. Regis San Francisco
125 3rd Street
San Francisco, CA 94103
3rd and Mission Streets
Gallery Ballroom, 2nd floor
This activity is supported by an educational grant from AtriCure, Inc.
This program is not part of the Heart Rhythm 2008 Official Scientific Sessions as planned by the Heart Rhythm Society Scientific Sessions Committee. This event is neither sponsored nor endorsed by the Heart Rhythm Society.
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 Newest Perspectives on Drug-Eluting Stents
Complimentary CME Accredited Dinner Meetings Click Here for More Info.
Miami, FL - Date: Friday, April 4, 2008 6:00pm EST -8:00 pm EST
Birmingham, AL - Date: Friday, May 9, 2008 6:00pm EST -8:00 pm EST
This activity is supported by an educational grant from Abbott Vascular.
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 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE
On Demand Web Archive
Non-Accredited
This activity is supported by an educational grant from Terumo Medical Corporation.
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 Pharmacoinvasive Management of Acute Coronary Syndrome: Incorporating the 2007 ACC/AHA Guidelines
Complimentary Accredited CME Program
This activity is supported by an educational grant from Sanofi-Aventis.
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 Varicose Veins: Causes, Symptoms, Diagnosis and Treatment of Chronic Venous Insufficiency
A Complimentary Accredited ON-DEMAND Webcast
This activity is supported by an educational grant from Diomed, Inc.
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 Create a Successful Vena Cava Filter Practice
Accredited CD
This activity is supported by an educational grant from Cook Incorporated and has been designed for Interventional Cardiologists, Vascular Surgeons, Fellows and Interventional Cardiovascular Nurses and Technologists.
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Webcast and Web Archives |
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 Achieving Optimal Outcomes in Carotid Stenting: Lessons Learned from Recent Clinical Trials
Complimentary Accredited ON DEMAND Webcast
Topics
1. EVA-3S & Space-Bumps in the road
2. CAPTURE 3500-Lesion morphology & Predictors for Stroke
3. CAPTURE II vs. EXACT 1500-Does open or Closed Cell Stent design really matter?
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Neurologists, Interventional Nurses and Technologists with an interest in the diagnosis and treatment of peripheral artery disease. |
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 Anticoagulation Techniques for Peripheral Vascular Interventions
Complimentary Accredited ON DEMAND Webcast
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Podiatric Physicians, Endovascular Allied Professionals, Endocrinologists, Wound Care Specialists, Directors of the Wound Care Clinic, and Primary Care Physicians, Pharmacists, Nurses and Technologists.
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 New Treatment Strategies for the Endovascular Approach to Critical Limb Ischemia: ADVANCEMENTS IN LIMB SALVAGE MEDICINE
Complimentary Accredited ON DEMAND Webcast
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Podiatric Physicians, Endovascular Allied Professionals, Endocrinologists, Wound Care Specialists, Directors of the Wound Care Clinic, and Primary Care Physicians, Pharmacists, Nurses and Technologists.
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 Reducing the Incidence of CIN during Cardiac Catheterization and PCI
Complimentary Accredited ON DEMAND
Educational Web Archive
This activity has been developed for nurses and technologists. |
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March 2007 Supplement
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On-Demand Webcast
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Archived Webcast
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© 2008 HMP Communications | All Rights Reserved
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Presented By: 
Release Date: December 8, 2006