congenital heart disease in the adult

Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 1 pps

Ngày tải lên : 13/08/2014, 12:20

... located in close proximity to the actual laboratory in order to support the minute-tominute activities of the laboratory including the changes in scheduling and assignments during each day The administrative ... catheterization laboratory the injector and then initiates the injection during the angiogram In some laboratories the nurse/technician in the control area also operates the start–stop of the ... applying the paddles and administering the current him/herself At the end of the procedure, the circulating nurse/technician assists the physicians in removing the table drapes and then applies the...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 2 ppsx

Ngày tải lên : 13/08/2014, 12:20

... veins is dependent more on actual feeling and seeing the vein The veins in the arms not have the ﬁxed relationships to the artery and other landmarks in the brachial area as they in the inguinal ... direction results in the catheter digging into the opposite wall of the vein or entering small side branches, which arise at the curve in the vein just as the catheter exits the tip of the sheath As ... skin between the skin puncture and the puncture into the vein This supports the wire beneath the skin and prevents the wire from bending or kinking in addition to preventing subcutaneous bleeding...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 3 pps

Ngày tải lên : 13/08/2014, 12:20

... artery The tip of the catheter is maintained pointing laterally in the right atrium (toward the patient’s right) when forming the atrial loop By continuing to advance the catheter in the right ... to the desired course and direction of the catheter within the body The stiff, preformed wire is introduced into the catheter with the purpose of deforming (deﬂecting) the tip of the catheter into ... further advancing the catheter, a large 180+° loop is formed within the right atrium until the tip of the catheter is pointing cephalad (Figure 5.22a) By rotating the whole 180+° loop in the catheter...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 4 pps

Ngày tải lên : 13/08/2014, 12:20

... elusive, “hiding” and clinging within the catheter, the plastic connecting tubing, in the junctions and stopcocks between the segments of tubing or even in the transducers themselves The only valid ... within the constantly flowing fluid, the rate of total flow is determined by measuring the difference in the concentrations of the indicator between the in ow and outflow samples The change in concentration ... data the catheter or tubing A kink in the catheter or pressure line will also dampen or obliterate the pressure Usually, however, a kink interrupts the pressure abruptly or intermittently as the...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 5 ppt

Ngày tải lên : 13/08/2014, 12:20

... entrance into the vein, centrally through the vein, and to the fixation point in the heart The cut-down for the lead extraction is usually on the anterior chest wall in the area of the subclavian vein ... entire in ation The final positioning, the in ation of the balloon in the left atrium, and the withdrawal of the balloon are the times when the adjunct use of the echocardiogram in the catheterization ... and into the left ventricle if there is significant slack on the shaft of the balloon catheter as the balloon is in ated If the balloon in ation continues with the balloon in the ventricle, the...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 6 ppt

Ngày tải lên : 13/08/2014, 12:20

... through the sheath and into the left ventricle During the introduction and the entire time the balloon catheter is being advanced within the sheath, both the sheath and the catheter are maintained ... catheter The stretching tube is advanced into and locked to the Lure™ lock hub of the inner tube of the catheter The inner tube with the contained metal stretching tube is advanced into the catheter, ... and the locking pin on the hub of the inner tube is locked into the slot on the central hub of the balloon catheter The fully inserted and locked inner and stretching tube elongates the otherwise...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 7 ppt

Ngày tải lên : 13/08/2014, 12:20

... straightening and then extra bowing of the wire curves within the heart lengthen the circumference of the curves in the wire, and when the wire is ﬁxed at the skin surface, the lengthening of the curves ... within the catheter, in turn, creates a new curve in the shaft of the catheter at the location where it enters the side of the stent and, in doing so, changes the angle of entrance of the catheter ... and increase the curvature of the sheath, the distance along the wire from the skin entry site to the lesion lengthens If the increasing circumference of this curve in the sheath/wire and, in...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 8 doc

Ngày tải lên : 13/08/2014, 12:20

... Both the material of the catheter and the internal diameter of the catheter are critically important in order to prevent the coil from “binding” within the lumen of the catheter during the delivery ... expansion of the stent(s), the wire is removed from the catheter and the catheter withdrawn The infant is maintained off the prostaglandin infusion Depending upon the status of the pulmonary ... to prevent the coil from “binding” within the catheter during the delivery through the catheter The internal diameter of the catheter must be sufﬁciently larger than the diameter of the coil wire...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 9 doc

Ngày tải lên : 13/08/2014, 12:20

... is introduced into the tiny sleeve While maintaining the ball on the device within the sleeve, the ball on the delivery/release wire is withdrawn into the sleeve by withdrawing the tumbler at the ... “marker” catheter introduced into the sheath in the left femoral vein The “right heart pressures and the right heart saturation “sweep” are acquired with either one or a combination of these catheters ... of the catheter The ball on the device will be locked into the tiny sleeve when the protuberance on the tumbler snaps into the small hole on the plastic latch The attached wires of the two tiny...

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Cardiac Catheterization in Congenital Heart Disease: Pediatric and Adult - Part 10 doc

Ngày tải lên : 13/08/2014, 12:20

... just within the distal tip of the catheter The purpose of the Mullins™ wire is to redirect and maintain the guiding catheter in its position against, and pointing directly at, the center of the atretic ... each individual patient The angle at the tip of the particular guiding catheter, which is positioned in the RVOT, should point the tip of the catheter directly at the other catheter in the pulmonary ... the tip of the catheter parallel to the long axis of the two discontinuous segments of the obstructed vessel Changing the guiding catheter, changing the curve of the guiding catheter and/or the...

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Báo cáo y học: " Chylothorax after surgery on congenital heart disease in newborns and infants – risk factors and efficacy of MCT-diet" pot

Ngày tải lên : 10/08/2014, 09:23

... diagnosed A lysis therapy in out of these patients was successful in reopening the vein, but resolved chylothorax only in In one patient who had a contraindication for a lysis therapy, chylothorax ... for the therapeutic approach Patients and methods We carried out a systematic retrospective review of our institutional database on all surgeries of congenital heart disease in children within their ... cardiac surgery are at the highest risk for chylothorax These patients’ risk is further increased in cases with secondary chest closure In the majority of the patients (71% in our study), chylous...

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báo cáo khoa học: " Morgagni’s diaphragmatic hernia mimicking a severe congenital heart disease in a newborn: a case report" ppsx

Ngày tải lên : 11/08/2014, 02:22

... even the most experienced physicians In this previously unreported case, compression of the heart by the bowel might have led to the incorrect diagnosis of congenital heart disease Even in this ... right shunt (Figure 5) The child was Figure Computed tomography scan of the chest The abdominal contents pass into the anterior mediastinum and compress the right side of the heart, Bassareo et al ... chest infections and gastrointestinal symptoms (vomiting, abdominal pain and bleeding) have been reported in subjects with previously undiagnosed Morgagni’s hernia The rarity of this CDH and the...

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Implementing electronic clinical reminders for lipid management in patients with ischemic heart disease in the veterans health administration: QUERI Series doc

Ngày tải lên : 11/08/2014, 05:21

... working within the existing structure of the network as we conducted the intervention Our original intent was to use a lagged design, introducing the intervention to the comparison half of the ... only in the intervention hospitals The reminders were installed in the intervention hospitals within a month after the kickoff meeting, although there was considerable variation among the intervention ... measure their perceptions of organizational readiness to change, and discussed the aggregate findings in the context of preparing system change They were trained in the installation and use of reminders...

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báo cáo khoa học: " Implementing electronic clinical reminders for lipid management in patients with ischemic heart disease in the veterans health administration: QUERI Series" ppsx

Ngày tải lên : 11/08/2014, 16:21

... working within the existing structure of the network as we conducted the intervention Our original intent was to use a lagged design, introducing the intervention to the comparison half of the ... only in the intervention hospitals The reminders were installed in the intervention hospitals within a month after the kickoff meeting, although there was considerable variation among the intervention ... measure their perceptions of organizational readiness to change, and discussed the aggregate findings in the context of preparing system change They were trained in the installation and use of reminders...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 1 pptx

Ngày tải lên : 14/08/2014, 07:20

... utilizing their individual expertise This book outlines the principles of dealing with such patients including the preferences of techniques and the hardware available The text is divided into ... to this emerging patient group Because there is very little written on the topic of pacemaker and ICD implantation in adult congenital heart disease, the authors have joined together to create ... instructive schematic drawings of congenital heart anatomy My sincerest appreciation to all Peter P Karpawich Pacing Options in the Adult Patient with Congenital Heart Disease Harry G Mond, MBBS,...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 2 potx

Ngày tải lên : 14/08/2014, 07:20

... occasion, the cephalic vein may break during lead insertion If the two leads cause a very tight ﬁt in the vein, it may, as a consequence, invaginate the vein into the subclavian vein The torn ... sewing in the valve, the lead can be positioned on the endocardial surface of the ventricle, using the approach just described via the atrium The sewing ring of the valve will then cover the ... vein retained guide wire technique Left: Two leads are passed along an intact cephalic vein Right: The cephalic vein is torn with pushing of the second lead into the subclavian vein The vein...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 3 docx

Ngày tải lên : 14/08/2014, 07:20

... retrograde towards the arm in the axillary vein or up into the neck in the internal jugular vein (Figure 7.4) Although this can usually be prevented by not peeling the introducer until the curved or ... advancement through the annuloplasty ring The broad stylet curve shown in Figure 7.2 was required There is a ball and cage mitral valve prosthesis (MVP) innominate vein toward the heart, but rather proceed ... preferable in patients with adult congenital heart disease requiring permanent cardiac pacing [62] C H APTER Consider steerable stylets or catheters An adult patient with congenital heart disease...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 4 pdf

Ngày tải lên : 14/08/2014, 07:20

... coronary sinus cannulation is considered in adults with congenital heart disease, it should be remembered that the venous drainage of the heart into the right atrium may not be normal In particular, ... outside the vein in the pacemaker pocket has also been suggested The lead is secured to the tissues via the lead collar, using slowly absorbable suture material The lead can then be drawn into the intravascular ... abnormal hearts [74] In turn depending on the presence or absence of a bridging brachiocephalic or innominate vein, and certain repaired congenital heart defects, the coronary sinus may be absent...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 5 doc

Ngày tải lên : 14/08/2014, 07:20

... shows the ventricular lead passing inferior without a bend as if into the ﬂoor of the right atrium and ﬁts nicely with the accompanying schematic Depending on its position in the ventricle, the ... or loops to the left instead of the right, yet the great arteries develop normally This inverts all the structures derived from the bulboventricular part of the heart, which includes the atrioventricular ... mechanisms have been postulated to explain the success of pacing for the congenital long QT interval This includes: • Decreasing the dispersion of refractoriness preventing critically timed premature...

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Pacing Options in the Adult Patient with Congenital Heart Disease - part 6 pot

Ngày tải lên : 14/08/2014, 07:20

... show the ventricular lead emerging from the coronary sinus looping in the right atrium and then passing to the ﬂoor of the right ventricle The atrial lead (At) lies against the lateral wall of the ... to show the ventricular lead emerging from the coronary sinus, looping in the large right atrium and passing through the tricuspid valve to the ﬂoor of the right ventricle (white arrow) The atrial ... reported with the incidence falling with advancing age, but still as high as 20% in the elderly [148] Atrial septal defects are also one of the most common congenital defects occurring in adults with...

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