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cardiac catheterization in patients with severe allergy

Ji-Yan Chen, Yong Liu, Ying-Ling Zhou, Ning Tan, Bin Zhang, Ping-Yan Chen, Li-Bing Chen
To assess the incidence of and risk factors for acute adverse drug reactions (ADRs) (occurring within 1 h) following iopromide administration in cardiac catheterization in Chinese 'real-world' practice. Acute ADRs following iopromide administration during coronary angiography or percutaneous coronary intervention (PCI) have not been systematically evaluated in China. TRUST was a prospective, multicenter, observational study conducted at 63 centers in China. Patients received iopromide (300 or 370 mgI/mL) during coronary angiography or PCI (n = 17,513)...
October 2015: International Journal of Cardiovascular Imaging
Priya Pillutla, Leigh C Reardon, Jamil A Aboulhosn
Major adverse reactions to iodinated radiocontrast media are an uncommon but serious complication of cardiac catheterizations. We present a case of a 52-year-old woman with a sinus venosus atrial septal defect and partial anomalous pulmonary venous connection status post repair who presented with superior vena cava graft obstruction. Two overlapping stents were placed within the superior vena cava using gadolinium, CO2 angiography and transesophageal echocardiography for visualization of the graft stenoses...
September 2014: Congenital Heart Disease
Elizabeth Juneman, Layth Saleh, Hoang Thai, Steven Goldman, Mohammad Reza Movahed
A history of severe allergic reaction to iodine contrast leading to anaphylactic shock presents a dilemma in patients requiring cardiac catheterization. As an alternative, gadolinium has been an interesting and potentially useful agent. However, gadolinium produces poor image quality and has been associated with significant arrhythmias in small case series. Furthermore, there is no consensus about the maximal allowable dose that can be administered to a patient. In the present report, a successful combination of gadolinium contrast with a power injector that produced adequate image quality in a patient with severe allergy to iodine contrast is described...
2012: Experimental and Clinical Cardiology
Giuseppe De Luca, Luca Venegoni, Sergio Iorio, Livio Giuliani, Paolo Marino
OBJECTIVES: The purpose of this study was to investigate the effects of increasing dose of intracoronary adenosine on fractional flow reserve (FFR) measurement. BACKGROUNDS: FFR is a validated method for the assessment of the severity of coronary artery stenosis. It is based on the change in the pressure gradient across the stenosis after the achievement of maximal hyperemia of the coronary microcirculation that may be obtained by either intracoronary bolus or intravenous infusion of adenosine...
October 2011: JACC. Cardiovascular Interventions
Swarnendra K Verma, Jonathan M Tobis
OBJECTIVES: The aim of this study was to examine the frequency and causes of surgical explantation of patent foramen ovale (PFO) closure devices. BACKGROUND: PFO has been linked with cryptogenic strokes, recurrent transient neurologic deficits, sleep apnea, decompression illness, and migraines. Several randomized trials are in progress to determine whether PFO closure is preferable to medical management in the treatment of patients with cryptogenic strokes or migraine...
May 2011: JACC. Cardiovascular Interventions
Maricel Ridella, Satish Bagdure, Kenneth Nugent, Cihan Cevik
BACKGROUND: Patients with anaphylaxis can have acute coronary syndromes secondary to allergic mediator effects on coronary vessels. Information about these cases is restricted to isolated case reports. METHODS: To review this topic we identified all cases in the PubMed database in English with searches using beta-lactams\adverse effects and several coronary disease MeSH terms. RESULTS: We analyzed 17 cases with a median age of 60 (range 13 to 72)...
March 2009: Inflammation & Allergy Drug Targets
W J Stewart, S M McSweeney, M A Kellett, D P Faxon, T J Ryan
Protamine is widely used for reversing systemic heparinization after cardiac catheterization. Although rare, major reactions to protamine that simulate anaphylaxis occasionally occur and have previously been associated only with an allergic reaction to fish. Because neutral protamine Hagedorn (NPH) insulin includes protamine, it might be anticipated that NPH insulin-dependent diabetic patients would develop sensitivity to protamine. Of 866 consecutive patients undergoing cardiac catheterization over a 20 month period, 651 received protamine for reversal of heparinization...
November 1984: Circulation
M E Weiss, N F Adkinson
Recent advances in medicine, such as cardiac catheterization, phoresis, dialysis, and cardiopulmonary bypass technology, have increased the need for heparin anticoagulation. To antagonize heparin's effect and prevent hemorrhagic complications after the procedure, protamine has likewise been used more frequently. With its increased use have come increased reports of adverse protamine reactions consisting of rash, urticaria, elevation of pulmonary artery pressure, systemic hypotension, and, at times, death. The elevation of pulmonary artery pressure, which appears to be a rather common occurrence in animals, may be an isolated finding without clinical consequences in humans...
October 1991: Clinical Reviews in Allergy
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