Interventional Cardiology3A978-1... · cularization by percutaneous transluminal coronary...
Transcript of Interventional Cardiology3A978-1... · cularization by percutaneous transluminal coronary...
Interventional Cardiology
Amar S. Kapoor Editor
Interventional Cardiology
With 135 Figures
Springer-Verlag New York Berlin Heidelberg London Paris Tokyo
Amar S. Kapoor, MD, Kaiser Foundation Hospital, University of Southern California, Los Angeles, CA 90027, USA
Library of Congress Cataloging-in-Publication Data Interventional cardiology/ Amar S. Kapoor, editor.
p. cm. Includes bibliographies and index.
ISBN-13: 978-1-4612-8145-0 DOl: 10.1007/978-1-4612-3534-7
e-ISBN-13: 978-1-4612-3534-7
1. Heart-Diseases-Treatment. I. Kapoor, Amar S. [DNLM: 1. Cardiology-methods. 2. Heart Diseases-diagnosis.
3. Heart Diseases-therapy. 4. Heart Function Tests-methods. WG 200 163] RC683.8.157 1988 616.1 '2-dc19 DNLMIDLC for Library of Congress
Printed on acid-free paper
© 1989 by Springer-Verlag New York Inc. Softcover reprint of the hardcover 1st edition 1989
88-16016 CIP
All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag, 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc. in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Typeset by Bi-Comp, Inc., York, Pennsylvania.
9 8 7 6 5 4 3 2 1
Dedicated to dear Rinder for her infinite patience and
to the interventional cardiologists who perform complex therapeutic acts
of finger calisthenics with finesse
Preface
In the last decade, invasive procedures in cardiology have blossomed at an unprecedented rate. There is a sea of facts that has to be organized, assimilated, and applied for sound cardiac practice. We have come a long way from our conventional palliative treatment of acute myocardial infarction to a much more aggressive stance of contemporary interventional cardiac care. Patients with cardiovascular instability are not only monitored in a protective environment, but are treated with innovative approaches requiring aggressive interventions.
The traditional role of the cardiologist has also changed because of interventional cardiology. Interventional cardiology embraces the application of cardiac procedures and active intervention for diagnostic or therapeutic studies. For example, management of acute myocardial infarction could involve early drug therapy to preserve ischemic or stunned myocardium, thrombolytic therapy for clot dissolution, and acute revascularization by percutaneous transluminal coronary angioplasty. Some patients may need intra-aortic balloon counterpulsation for stabilization, whereas still a small number of patients may need electrophysiologic studies and implantation of antitachycardia devices or automatic defibrillators. Eventually, an occasional patient who develops end-stage ischemic cardiomyopathy may require cardiac assist devices and cardiac transplantation.
Interventions have become routine accepted practice. In this book, emphasis is placed on the indications, techniques, results, and merits of each procedure. Details of each procedure, instrumentation required, and the techniques are highlighted. This book is divided into five parts.
Part I discusses general principles of cardiac catheterization, hemodynamic measurements, cineangiographic views, and coronary angiography. Cardiac catheterization is fundamental for all invasive procedures, and one needs to have a solid background in this procedure before contemplating interventional cardiology.
Part II deals with diagnostic interventions. These are very important for precise and accurate determination of cardiac dysfunction. This kind of hemodynamic or electrophysiologic information is crucial for therapeutic decisions.
Part III details therapeutic interventions. This is an area where the
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medical technology and complexity of cardiac procedures have grown exponentially. In this section, the latest technical and therapeutic information is provided in a practical format. All the interventional procedures in pediatric cardiology are discussed at length.
In Part IV the various facets of coronary angioplasty and its applications in different subsets of patients are discussed in depth. Coronary angioplasty is a highly technical procedure, requiring greater skills and care than routine coronary angiography. In this section on coronary interventions, there is also an explosion of information and technology with which we should become familiar. An attempt is made to address all these complex topics in a practical format.
Laser angioscopy and angioplasty are still investigational, but will get clinical application in the near future. In this field, there will be a starburst of information and innovations requiring updating. A glimpse into the future is provided.
Part V deals with cardiovascular crises and their management by acute pharmacologic interventions. In the setting of a cardiac intensive care unit, one must not only be knowledgeable about the pathophysiology of cardiovascular disease, but be well-versed in the pharmacology of cardiac drugs and their timely and appropriate use. In the management of acute myocardial infarction, we have come to know time is of the essence, and acute pharmacologic intervention becomes the "procedure" in the selected patient.
Thus, this book aspires to provide the guidelines for the modern cardiologist of today-one who uses modern techniques and technology and modern drugs for the management and prevention of cardiac disease"the interventional cardiologist."
AMAR S. KAPOOR
Contents
Preface ... Contributors
Part I Invasive Procedures
The Scope of Interventions in Cardiovascular Conditions AMAR S. KAPOOR ................ .
2 Techniques of Cardiac Catheterization and Coronary Angiography AMAR S. KAPOOR
3 Coronary Blood Flow and Coronary Vascular Reserve TERRENCE J.W. BARUCH, AMAR S. KAPOOR, and
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3
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PETER R. MAHRER . . . . . . . . . . . . . . . . . . .. 22
4 Quantitative Coronary Arteriography BUDGE H. SMITH, B. GREG BROWN, and HAROLD T. DODGE 35
5 Hemodynamic Monitoring by Pulmonary Artery Catheterization SURESH RAMAMURTI and AMAR S. KAPOOR.
6 Outpatient Cardiac Catheterization PETER R. MAHRER . . . . . . .
7 The Evolution of Coronary Artery Disease: New Definitions from Coronary Angioscopy JAMES S. FORRESTER, ANN HICKEY, FI~ANK LITVACK, and
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WARREN GRUND FEST. . . . . . . . . . . . . . . . . 69
x Contents
Part II Diagnostic Interventions
8 Interventions in the Evaluation of Valvular Heart Disease INDUBALA N. VARDHAN and AMAR S. KAPOOR. . 81
9 Interventions for Evaluation of Myocardial Ischemia AMAR S. KAPOOR, DIANE SOBKOWICZ, and DAVID E. BLUMFIELD ............. .
10 Introduction to Clinical Electrophysiology DONALD G. RUBENSTEIN and CAROL ZAHER
11 Invasive Electrophysiologic Studies in the Evaluation and Treatment of Patients with Ventricular Arrhythmias
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NICHOLAS J. STAMATO and MARK E. JOSEPHSON. . . . . 119
12 Electrophysiologic Approach to Patients with Supraventricular Tachycardia DONALD G. RUBENSTEIN and CAROL ZAHER
13 Technique of Pericardiocentesis and Intrapericardial Drainage
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AMAR S. KAPOOR . . . . . . . . . . . . . . . . . . . . 146
14 Endomyocardial Biopsy Techniques and Interpretation AMAR S. KAPOOR and MIR ALI . . . . . . .
15 Dipyridamole Thallium for Evaluating Coronary Artery Disease DIANE SOBKOWICZ and DAVID E. BLUMFIELD.
Part III Therapeutic Interventions
16 Principles and Techniques of Intra-aortic Balloon Pump Counterpulsation
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SHALE GORDON . . . . . . . . . . . . . . . . . . 171
17 Temporary and Permanent Pacemakers AMAR S. KAPOOR ........ .
18 Automatic Implantable Defibrillator: Six-Year Clinical Experience ENRICO P. VELTRI, MORTON M. MOWER, and MICHEL MIROWSKI . . . . . . . . . . . . .
19 Catheter Ablation Techniques for Treatment of Cardiac Arrhythmias
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MELVIN M. SCHEINMAN . . . . . . . . . . . . . . . . . 201
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20 Interventional Pediatric Cardiac Catheterization ZUHDI LABABIDI and IHAB ATTIA . . . . . . . 214
21 Balloon Aortic Valvuloplasty BRICE LET AC and ALAIN CRIBIER ........... 239
22 Peripheral Laser Thermal Angioplasty TIMOTHY A. SANBORN . . . . . . . . . . . . . . . . . . 254
Part IV Coronary Interventions
23 Practical Aspects of Coronary Angioplasty AMAR S. KAPOOR .......... .
24 Complex Coronary Angioplasty: The Outcome and Long-term Effect of Angioplasty in Multivessel Coronary Disease and Multiple Lesion Anigoplasty
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GERALD DORROS, RUBEN F. LEWIN, and LYNNE MATHIAK. . 281
25 Management of Early and Late Complications of Coronary Angioplasty AMAR S. KAPOOR and PETER R. MAHRER. . . . .... 306
26 Percutaneous Transluminal Coronary Stenting: ANew Approach to Unresolved Problems in Coronary Angioplasty ULRICH SIGWART, SVEIN GOLF, URS KAUFMANN, LUKAS KAPPENBERGER, ADAM FISCHER, and HOSSEIN SADEGHI . . . . . . . . . . . . . . . . . . . . 314
27 Laser Angioplasty of the Coronary Arteries GARRETT LEE, REGINALD I. Low, AGUSTIN J. ARGENAL, ROLF G. SOMMERHAUG, MING C. CHAN, and DEAN T. MASON 319
Part V Acute Pharmacologic and Surgical Interventions
28 Platelet Inhibitor Drugs in Coronary Artery Disease and Coronary Intervention DOUGLAS H. ISRAEL, BERNARDO STEIN, and VALENTIN FUSTER . . . . . . . . . . . . . . . . . . . . 329
29 Thrombolysis in Acute Myocardial Infarction DAVID E. BLUMFIELD . . . . . . . . .. ....... 355
30 Interventional Approach in the Management of Cardiogenic Shock AMAR S. KAPOOR . . . . . . . . . . . . . . . . . . . . 368
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31 Emergency Coronary Artery Bypass Surgery for Acute Coronary Syndromes SAMUEL L. SELINGER, RALPH BERG JR, WILLIAM S. COLEMAN, JACK J. LEONARD, and
Contents
MARCUS A. DEWOOD. . . . . . . . . . . . . . . . . . . 377
32 Cardiac Transplantation DAVIS DRINKWATER, LYNNE WARNER STEVENSON, and HILLEL LAKS . . . . . . . . . . . . . . . . . . . . . . 387
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Contributors
MIR ALI, MD
Fellow in Cardiology, Kaiser Foundation Hospital, Los Angeles, California, USA
AGUSTIN J. ARGENAL, MD, FACC
Director, Cardiac Catheterization Laboratory, Northern California Heart and Lung Institute, Concord, California, USA
IHAB ATTIA, MD
Fellow in Cardiology, University of Missouri Hospital and Clinics, Columbia, Missouri, USA
TERRENCE J. W. BARUCH, MD
Fellow in Cardiology, Kaiser Foundation Hospital, Los Angeles, California, USA
RALPH BERG JR, MD
Cardiovascular Surgery, Sacred Heart Medical Center, Spokane, Washington, USA
DAVID E. BLUMFIELD, MD, FACC
Director, Coronary Care Unit, Kaiser Foundation Hospital, Los Angeles, California, USA
B. GREG BROWN, MD, PHD
Professor of Medicine, University of Washington, School of Medicine, Seattle, Washington, USA
MING C. CHAN, MD
Professor of Medicine, Chairman, Department of Medicine, Beijing Medical University, Beijing, China
WILLIAM S. COLEMAN, MD, FACC, FACS
Caridovascular Surgery, Sacred Heart Medical Center, Spokane, Washington, USA
ALAIN CRISlER, MD
Associate Professor of Cardiology, Centre Hospitalo-U niversitaire de Rouen, Rouen, France
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MARCUS A. DEWOOD, MD, FACC
Director, Cardiology Research, Sacred Heart Medical Center, Spokane, Washington, USA
HAROLD T. DODGE, MD, FACC
Professor of Medicine, University of Washington, Director, Division of Cardiology, Seattle, Washington, USA
GERALD DORROS, MD, FACC
Assistant Clinical Professor of Medicine, St. Luke's Medical Center, Milwaukee, Wisconsin, USA
DAVIS DRINKWATER, MD
Assistant Professor of Surgery, Cardiothoracic Surgery, University of California, Los Angeles, California, USA
ADAM FISCHER, MD
Staff Cardiovascular Surgeon, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
JAMES S. FORRESTER, MD, FACC
Professor of Medicine, University of California, Director of Cardiovascular Research, Cedars-Sinai Medical Center, Los Angeles, California, USA
VALENTIN FUSTER, MD, FACC
Arthur M. and Hilda A. Master Professor of Medicine, Mount Sinai School of Medicine, Chief of Cardiology, Mount Sinai Medical Center, New York, New York, USA
SVEIN GOLF, MD
Fellow in Interventional Cardiology, Centre Hospitalier U niversitaire Vaudois, Lausanne, Switzerland
SHALE GORDON, MD
Staff Cardiologist, Kaiser Medical Center, Bellflower, California, USA
WARREN GRUND FEST , MD
Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA
ANN HICKEY, MD
Staff Cardiologist, Cedars Sinai Medical Center, Los Angeles, California, USA
DOUGLAS ISRAEL, MD
Fellow in Cardiology, Mount Sinai School of Medicine, New York, New York, USA
MARK E. JOSEPHSON, MD, FACC
Director, Division of Cardiology, Robinette Foundation Professor of Medicine, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA
AMAR S. KAPOOR, MD, FACP, FACC
Director of Cardiovascular Research, Regional Medical Director of Heart Transplant Program, Kaiser Foundation Hospital, Clinical
Contributors
Associate Professor of Medicine, University of Southern California, Los Angeles, California, USA
LUKAS KAPPENBERGER, MD
Professor of Medicine, Chief of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
URS KAUFMANN, MD
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Staff Cardiologist, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
ZUHDI LABABIDI, MD, FACC
Director, Division of Pediatric Cardiology, Professor of Pediatric Cardiology, University of Missouri Hospital and Clinics, Columbia, Missouri, USA
HILLEL LAKS, MD, FACS
Director, Cardiovascular Surgery and Cardiac Transplantation, Professor of Surgery, University of California, Los Angeles, California, USA
GARRET T. LEE, MD, FACC
Director of Research, Northern California Heart and Lung Institute, Mount Diablo Hospital Medical Center, Concord, California, USA
JACK J. LEONARD, MD
Cardiovascular Surgery, Sacred Heart Medical Center, Spokane, Washington, USA
BRICE LETAC, MD
Professor of Cardiology, Chief of Cardiology, Centre Hospitalo-Universitaire de Rouen, Rouen, France
RUBEN F. LEWIN, MD
Isadore Feuer Fellow in Interventional Cardiology, St. Luke's Medical Center, Milwaukee, Wisconsin, USA
FRANK LITVACK, MD
Assistant Professor of Medicine, University of California, Director, Catheterization Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
REGINALD 1. Low, MD, FACC
Interventional Cardiologist, Diagnostic and Interventional Cardiology Consultants, Sacramento, California, USA
PETER R. MAHRER, MD, FACC
Director, Division of Cardiology, Director, Regional Cardiac Catheterization Laboratory, Kaiser Foundation Hospital, Clinical Professor of Medicine, University of Southern California, Los Angeles, California, USA
DEAN T. MASON, MD, FACC
Physician-in-Chief, Western Heart Institute, Chairman, Department of Cardiology, St. Mary's Hospital Medical Center, San Francisco, California, USA
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LYNNE MA THIAK, RN St. Luke's Medical Center, Milwaukee, Wisconsin, USA
MICHEL MIROWSKI, MD, FACC Director, Coronary Care Unit, Professor of Medicine, John Hopkins School of Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
MORTON M. MOWER, MD, FACC Director, Cardiology Division, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
SURESH RAMAMURTI, MD Staff Cardiologist, Kaiser Medical Center, Panorama City, California, USA
DONALD G. RUBENSTEIN, MD Staff Cardiologist, Kaiser Medical Center, Panorama City, California, USA
HOSSEIN SADEGHI, MD Professor of Surgery, Chief of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
TIMOTHY A. SANBORN, MD Associate Professor of Medicine, Mount Sinai School of Medicine, Director, Interventional Cardiology Research and Laser Angioplasty Program, Mount Sinai Hospital, New York, New York, USA
MELVIN M. SCHEINMAN, MD, FACC Director, Electrophysiology Laboratory, Moffit Hospital, Professor of Medicine, University of California, San Francisco, California, USA
SAMUEL L. SELINGER, MD, FACS, FACC Cardiovascular Surgery, Sacred Heart Medical Center, Spokane, Washington, USA
ULRICH SIGWART, MD, FACC Associate Professor of Medicine, Centre Hospitalier Universitaire Vaudois, Division of Cardiology, Lausanne, Switzerland
BUDGE H. SMITH, MD Acting Instructor, University of Washington, Division of Cardiology, Seattle, Washington, USA
DIANE SOBKOWICZ, MD Fellow in Cardiology, Kaiser Foundation Hospital, Los Angeles, California, USA
ROLF G. SOMMERHAUG, MD Chief, Cardiac, Thoracic and Vascular Surgery, Northern California Heart and Lung Institute, Concord, California, USA
NICHOLAS J. STAMATO, MD, FACC Clinical Assistant Professor of Medicine, Loyola University, Stritch School of Medicine, Midwest Heart Specialists, Lombard, Illinois, USA
Contributors
BERNARDO STEIN, MD
Fellow in Cardiology, Mount Sinai School of Medicine, New York, New York, USA
LYNNE WARNER STEVENSON, MD
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Assistant Professor of Medicine, University of California, Los Angeles, California, USA
INDUBALA N. V ARDHAN, MD
Fellow in Cardiology, Kaiser Foundation Hospital, Los Angeles, California, USA
ENRICO P. VELTRI, MD
Director, Sudden Death Prevention Program, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
CAROL ZAHER, MD, FACC
Chief of Cardiology and Director of Electrophysiology, Kaiser Medical Center, Panorama City, California, USA