By Gianfranco Butera, Massimo Chessa, Andreas Eicken, John Thomson
This instruction manual is a perfect, up to date consultant to the applying of catheter-based interventions around the complete sufferer age diversity, from fetal existence via to maturity. transparent guideline is obtainable on recommendations of vascular entry, valve dilatation, angioplasty, stent implantation, illness closure, illness construction, pulmonary valve implantation and the hybrid strategy, in addition to miscellaneous different approaches. issues are approached utilizing a step by step layout, making sure that the reader will instantly be capable of entry details suitable to day-by-day perform. Many explanatory figures and drawings are incorporated in every one bankruptcy with a view to make clear extra the best way to plan, practice and review diagnostic and interventional systems within the box of congenital center disorder. cognizance is interested in very important information and tips that would help in attaining optimum results and an appendix comprises extra common equations and BSA and oxygen intake charts.
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Extra resources for Cardiac Catheterization for Congenital Heart Disease: From Fetal Life to Adulthood
17 Contrast Delivery In general, for anatomic definition, contrast should be delivered through the catheter as rapidly as possible, generally in 1 or 2 s. 5–1 cc/kg in pulmonary branches (maximum volume of 30–40 cc per injection). A high flow rate is much important than volume for a good anatomic definition. Viscosity of contrast 4 Angiography: Basics and Contrast Media 31 medium is inversely related to temperature; therefore, warming the contrast medium may facilitate high-flow injection through lower profile catheters.
2 Position Patients Properly (Isocentered and Straight on the Table) Having patients in the isocenter keeps the heart at the center of the field whichever angulated views are used. Prolonged fluoroscopy during changes in angiographic projection is therefore avoided. ) with minimal trial and error or wasted fluoroscopy. 3 Use the Lowest Acceptable Frame Rate During Pulsed Fluoroscopy and Cine Angiography Always use pulsed fluoroscopy, never continuous fluoroscopy. , fast-moving vs. slow-moving; venous or arterial).
Zunzunegui 32 COO- CATION + I I Iothalamate Diatrizoate R R I IONIC MONOMER (OH)n I I Iopromide Iopamidol lohexol Ioversol Iopentol (OH)n (OH)n I NON-IONIC MONOMER (OH)n I (OH)n I I I (OH)n I NON-IONIC DIMER Iotrolan Iodixanol (OH)n I Fig. 1 Chemical structure of iodinated contrast agents and examples of contrast media 4 Angiography: Basics and Contrast Media 33 Since the purpose of these agents is to deliver iodine in sufficient concentration for imaging, the ratio of iodine atoms to particles in solution becomes important.