Optimal Technique for Catheterizing the Pulmonary Arteries Without Dedicated Pulmonary Catheters

2018 ◽  
Author(s):  
George Carberry ◽  
Michael Brunner
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Computed Tomography Angiography ◽  
Femoral Vein ◽  
Pulmonary Arteries ◽  
High Resolution Computed Tomography ◽  
Pulmonary Arteriography ◽  
Pulmonary Artery Catheters ◽  
Diagnostic Catheter

With the emergence of high-resolution computed tomography angiography, the number of transcatheter pulmonary arteriograms being performed has steeply declined. For this reason, many interventional departments no longer stock dedicated pulmonary artery catheters such as the pre-shaped 7 Fr Grollman catheter for a femoral vein approach. Interventionalists are therefore required to improvise with catheters that are available on hand. Transcatheter pulmonary arteriography may be indicated when dedicated pulmonary artery catheters are not available for use. In this chapter, a step-by-step approach is described and accompanied by illustrations demonstrating how a common diagnostic catheter, the 5 Fr Omniflush catheter, can be used to perform pulmonary arteriography.

scholarly journals Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension

2020 ◽  
Vol 6 (1) ◽  
pp. 00232-2019
Author(s):  
Pailin Ratanawatkul ◽  
Andrea Oh ◽  
J. Caleb Richards ◽  
Jeffrey J. Swigris
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Predictive Value ◽  
High Specificity ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Entire Cohort ◽  
Right Heart Catheterisation

BackgroundOn high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension.MethodsWe retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD).ResultsOf 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PA:Ao) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PA:Ao was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PA:Ao, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= −0.24).ConclusionsFindings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PA:Ao ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PA:Ao had higher specificity in COPD.

Surgical management of iatrogenic occluded left pulmonary artery

2018 ◽  
Vol 27 (5) ◽  
pp. 396-399
Author(s):  
Ali Sadeghpour Tabaie ◽  
Mohaddeseh Behjati ◽  
Hojjat Mortezaeian ◽  
Hamid Reza Pouraliakbar ◽  
Behshid Ghadrdoost ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Computed Tomography Angiography ◽  
Ductus Arteriosus ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Artery Occlusion ◽  
Patent Ductus

A 4-year-old boy developed dyspnea 18 months after attempted surgical patent ductus arteriosus closure using a clip that was inadvertently placed on the left pulmonary artery, followed by reoperation to repair the left pulmonary artery with a patch and re-close the ductus. Computed tomography angiography confirmed a large patent ductus arteriosus, left pulmonary artery occlusion, and patent left pulmonary veins. Therefore, a third surgery was performed for suture closure of the ductus and left pulmonary artery repair with an interposition tube graft. Follow-up by transthoracic echocardiography and computed tomography angiography showed good flow in the left and right pulmonary arteries.

scholarly journals Ultra-High-Resolution Computed Tomography Angiography for Assessment of Coronary Artery Stenosis

2018 ◽  
Vol 82 (7) ◽  
pp. 1844-1851 ◽  
Author(s):  
Sadako Motoyama ◽  
Hajime Ito ◽  
Masayoshi Sarai ◽  
Yasuomi Nagahara ◽  
Keiichi Miyajima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Resolution ◽  
Computed Tomography Angiography ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
High Resolution Computed Tomography

Predictors of Pulmonary Hypertension on High-resolution Computed Tomography of the Chest in Systemic Sclerosis: A Retrospective Analysis

2010 ◽  
Vol 61 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Anoop Kumar Pandey ◽  
Pearce Wilcox ◽  
John R. Mayo ◽  
Donald Sin ◽  
Robert Moss ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Maximum Diameter ◽  
Imaging Features ◽  
High Resolution Computed Tomography ◽  
Pulmonary Artery Diameter

Purpose To evaluate the imaging features on high-resolution computed tomography (HRCT) of the chest and the clinical parameters that are associated with pulmonary hypertension in systemic sclerosis. We specifically investigated whether main pulmonary artery (MPA) diameter and burden of lung fibrosis are predictors of pulmonary hypertension in these patients. Methods We retrospectively retrieved the database information of patients with systemic sclerosis seen at our hospital between January 2007 and December 2008. A total of 75 patients had HRCT of the chest, pulmonary function testing (PFT), and echocardiography within 6 months of each other. The echocardiography images were reviewed by a level-3 echocardiographer, and 29 cases were excluded because of suboptimal evaluation of pulmonary artery (PA) pressure. Peak PA pressures and PFT of the remaining 46 cases (43 women and 3 men) were charted. The PFT included total lung capacity (TLC), diffusion capacity of lung for carbon monooxide (DLCO) and the ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC). The HRCT of the chest of each patient was read by a chest radiologist. The extent of ground glass, reticulation, and honeycombing was objectively scored. The maximum diameter of the main pulmonary artery (MPAD) and ascending aorta were measured. The ratio of main pulmonary artery diameter and ascending aortic diameter (MPAD/AD) and ratio of main pulmonary artery diameter and body surface area (MPAD/BSA) were also calculated. Results Statistical analysis done by using a multivariate model showed that the calculated fibrotic score strongly correlated with peak PA pressures ( P < .001). MPAD ( P = .0175), and the ratio MPAD/AD ( P = .0102) also showed a statistically significant correlation with peak PA pressures. By using stepwise regression analysis, the fibrotic score was found to be the most reliable independent predictor of pulmonary hypertension. Conclusion HRCT-determined severity and extent of pulmonary fibrosis may be helpful in screening for pulmonary hypertension in patients with systemic sclerosis.

scholarly journals Definitive Diagnosis of Pulmonary Artery Sling in a Critically Ill Infant With High-Resolution Computed Tomography

Circulation ◽  
2007 ◽  
Vol 115 (15) ◽  
Author(s):  
Phalla Ou ◽  
David S. Celermajer ◽  
Gabriella Agnoletti ◽  
Francis Brunelle ◽  
Pascal Vouhé ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Critically Ill ◽  
Definitive Diagnosis ◽  
Pulmonary Artery Sling ◽  
High Resolution Computed Tomography
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