Objective: The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites.
Design: A prospective observational study.
Setting: Tertiary care cardiac center.
Participants: Cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery.
Interventions: Waveform-derived CO monitoring through radial and femoral artery cannulation using a FloTrac/Vigileo system.
Measurements And Main Results: Twenty-seven consecutive cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery were included in the study. Cardiac output was measured sequentially by the arterial pressure waveform analysis method from radial and femoral arterial sites and compared with simultaneously measured TEE-derived CO. Cardiac output data were obtained in triplicate at 6 predefined time intervals: before and after sternotomy, 5, 15, and 30 minutes after separation from CPB and prior to shifting the patient out of the operating room. The overall bias of the study was 0.11 and 0.27, the percentage error was 19.31 and 18.45, respectively, for radial and femoral arterial waveform-derived CO values as compared with TEE-derived CO measurements. The overall precision as compared with the TEE-derived CO values was 16.94 and 15.95 for the radial and femoral cannulation sites, respectively. The bias calculated by the Bland-Altman method suggested that CO measurements from the radial arterial site were in closer agreement with TEE-derived CO values at all time periods, and the relation was not affected by CPB. However, percentage error and precision calculations showed that CO values derived from the femoral arterial waveform were in closer agreement, albeit marginally, with the TEE values at all time points.
Conclusions: Both the radial and femoral arterial pressure waveform-derived CO measurements were comparable with the TEE measurements during the various stages of the cardiac surgery. Although the femoral cannulation site provided marginally better correlation with the reference TEE-derived CO values based on the precision and percentage error analysis; this may not be significant clinically and either of the arterial cannulation sites can be used reliably for CO measurements in clinical practice. Cardiopulmonary bypass had no impact on the radial and femoral artery pressure waveform-derived CO measurements.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1053/j.jvca.2017.02.016 | DOI Listing |
Int J Cardiovasc Imaging
January 2025
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Endovascular treatment (EVT) for patients with lower extremity artery disease is widely used as a less invasive alternative to surgical bypass. Recently, transradial artery intervention has gained popularity owing to its minimally invasive nature. The distance from the radial artery to the target vessel is critical for success; however, effective pre-assessment methods have not yet been established.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: We aim to share our experience of transradial access (TRA) for cerebral angiography and intervention in five patients ranging from 6 days to 7 months of age.
Methods: In this institutional review board-approved, retrospective case series, we reviewed all patients who underwent TRA for cerebral angiography with and without intervention. We describe three techniques for radial artery cannulation, namely: (1) bareback; (2) with a micropuncture sheath; and (3) with an intravenous catheter.
Prog Cardiovasc Dis
January 2025
Charles R Drew University School of Medicine, Los Angeles, CA, United States of America; VA Long Beach Healthcare System, Long Beach, CA, United States of America. Electronic address:
Vascular access for coronary, peripheral, and structural interventions has changed significantly over the past two decades. The evolving demand for both large-bore access for valvular interventions and mechanical support devices, and for safer access for coronary interventions, in patients with comorbidities have driven progress in these areas. This review will provide an overview of the techniques of arterial access in the femoral, forearm (radial and ulnar), and alternative (transcarotid, transaxillary, and transcaval) locations based on the latest evidence and experience.
View Article and Find Full Text PDFCurr Cardiol Rep
January 2025
Division of Cardiology, NYU Grossman School of Medicine, New York, NY, USA.
Purpose Of Review: This review assesses the outcomes of coronary interventions in patients with liver cirrhosis and coronary artery disease (CAD), focusing on the clinical challenges posed by cirrhosis-related hemodynamic and coagulopathic changes. It highlights essential considerations for managing these patients, who have an increased risk of adverse events during coronary procedures.
Recent Findings: Recent studies have shown that patients with liver cirrhosis undergoing PCI experience significantly higher mortality rates compared to non-cirrhotic patients, particularly in the context of STEMI and NSTEMI.
CVIR Endovasc
January 2025
Radiology Department, The Princess Alexandra Hospital, Hamstel Road, Harlow, CM20 1QX, UK.
Background: This is a single-centre prospective observational study examining radial access in 62 Prostatic Artery Embolisation (PAE) procedures. Evaluation of left radial artery diameter using high frequency ultrasound before and after administration of sublingual glycerl trinitrate (GTN). Pre-procedure questionnaires calculating symptom severity score compared with post-procedure.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!