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Event Rates for Commonly Performed Cardiovascular Procedures

Event Rates for Commonly Performed Cardiovascular Procedures. Complete List of Contraindications to Ultrasound Contrast Agents. Right-to-left, bi-directional, or transient right-to-left cardiac shunts Worsening or clinically unstable heart failure

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Event Rates for Commonly Performed Cardiovascular Procedures

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  1. Event Rates for Commonly Performed Cardiovascular Procedures

  2. Complete List of Contraindications to Ultrasound Contrast Agents • Right-to-left, bi-directional, or transient right-to-left cardiac shunts • Worsening or clinically unstable heart failure • Acute myocardial infarction or acute coronary syndromes • Serious ventricular arrhythmias or high risk for arrhythmias due to prolongation of the QT interval • Respiratory failure, as manifest by signs or symptoms of carbon dioxide retention or hypoxemia • Severe emphysema, pulmonary emboli or other conditions that cause pulmonary hypertension due to compromised pulmonary arterial vasculature • Hypersensitivity to perflutren

  3. Complete List of Absolute Contraindications to Cardiac Catheterization “The only absolute contraindication to cardiac catherization is refusal of a mentally competent patient to consent to the procedure” Grossman W. Current practice standards. In: Baim DS and Grossman W, editors. Cardiac Catheterization, Angiography and Intervention. Baltimore, MD: Williams and Wilkins, 1996:9-16

  4. Pseudocomplication Complications occurring after any medical pocedure may be attributable to • the procedure itself • progression of underlying disease state (pseudocomplication)

  5. Pseudocomplication Hildner et al. Pseudocomplications of cardiac catherization. Chest 1973;63:15-17 Serious adverse events are relatively common in patients who are “sick enough” to warrant invasive testing

  6. ACC/AHA/ASE 2003 Guidelines Update for the Clinical Application of Echocardiography

  7. ACC/AHA/ASE 2003 Guidelines Update for the Clinical Application of Echocardiography “Echocardiographic contrast agents may improve diagnosis in free wall rupture and in identifying intracardiac thrombus.”

  8. Contrast Echocardiography is Superior to Tissue Harmonics for Assessment of Left Ventricular Function in Mechanically Ventilated Patients Conversion of non-diagnostic to diagnostic study % Kornbluth et al. Am Heart J 2000;140:291-6

  9. Contrast Echocardiography is Superior to Tissue Harmonics for Assessment of Left Ventricular Function in Mechanically Ventilated Patients Wall motion scoring possible 1/5 of mechanically ventilated patients will require TEE if contrast contraindicated % Kornbluth et al. Am Heart J 2000;140:291-6

  10. Contrast Echocardiography Clarifies Uniterpretable Wall Motion in Intensive Care Unit Patients % of patients with uniterpretable left ventricular function % Reilly JP et al. J Am Coll Cardiol 2000;35:485-90

  11. Diagnostic Accuracy and Cost-Effectiveness of Contrast Echocardiography on Evaluation of Cardiac Function in Technically Very Difficult Patients in the Intensive Care Unit Excellent or Adequate Endocardial Visualization % Yong et al. Am J Cardiol 2002;89:711-718

  12. Complications of Transesophageal Echocardiography Seward JB et al. J Am Soc Echocardiogr 1992;5:228

  13. Complications of Transesophageal Echocardiography Mortality rate = 1/10,000 Daniel WG et al. Circulation 1991;83:17-821

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