Interventional Cardiology

423 Pages·1989·13.13 MB·English

by  Amar S. Kapoor (auth.)

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/A mar S. Kapoor, editor.
p. cm.
Includes bibliographies and index.
ISBN-13: 978-1-4612-8145-0 e-ISBN-13: 978-1-4612-3534-7
DOl: 10.1007/978-1-4612-3534-7
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 88-16016
CIP
Printed on acid-free paper
© 1989 by Springer-Verlag New York Inc.
Softcover reprint of the hardcover 1st edition 1989
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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 in
farction to a much more aggressive stance of contemporary interventional
cardiac care. Patients with cardiovascular instability are not only moni
tored in a protective environment, but are treated with innovative ap
proaches requiring aggressive interventions.
The traditional role of the cardiologist has also changed because of
interventional cardiology. Interventional cardiology embraces the appli
cation of cardiac procedures and active intervention for diagnostic or
therapeutic studies. For example, management of acute myocardial in
farction could involve early drug therapy to preserve ischemic or stunned
myocardium, thrombolytic therapy for clot dissolution, and acute revas
cularization 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 defibril
lators. Eventually, an occasional patient who develops end-stage isch
emic 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, hemody
namic measurements, cineangiographic views, and coronary angiogra
phy. Cardiac catheterization is fundamental for all invasive procedures,
and one needs to have a solid background in this procedure before con
templating 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
viii Preface
medical technology and complexity of cardiac procedures have grown
exponentially. In this section, the latest technical and therapeutic infor
mation 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 applica
tions 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 inter
ventions, 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 se
lected patient.
Thus, this book aspires to provide the guidelines for the modern cardi
ologist 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 ... vii
Contributors xiii
Part I Invasive Procedures
The Scope of Interventions in Cardiovascular Conditions
AMAR S. KAPOOR ................ . 3
2 Techniques of Cardiac Catheterization and
Coronary Angiography
AMAR S. KAPOOR 10
3 Coronary Blood Flow and Coronary Vascular Reserve
TERRENCE J.W. BARUCH, AMAR S. KAPOOR, and
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. 48
6 Outpatient Cardiac Catheterization
PETER R. MAHRER . . . . . . . 63
7 The Evolution of Coronary Artery Disease: New Definitions
from Coronary Angioscopy
JAMES S. FORRESTER, ANN HICKEY, FI~ANK LITVACK, and
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 ............. . 89
10 Introduction to Clinical Electrophysiology
DONALD G. RUBENSTEIN and CAROL ZAHER 100
11 Invasive Electrophysiologic Studies in the Evaluation and
Treatment of Patients with Ventricular Arrhythmias
NICHOLAS J. STAMATO and MARK E. JOSEPHSON. . . . . 119
12 Electrophysiologic Approach to Patients with
Supraventricular Tachycardia
DONALD G. RUBENSTEIN and CAROL ZAHER 133
13 Technique of Pericardiocentesis and Intrapericardial Drainage
AMAR S. KAPOOR . . . . . . . . . . . . . . . . . . . . 146
14 Endomyocardial Biopsy Techniques and Interpretation
AMAR S. KAPOOR and MIR ALI . . . . . . . 154
15 Dipyridamole Thallium for Evaluating Coronary
Artery Disease
DIANE SOBKOWICZ and DAVID E. BLUMFIELD. 161
Part III Therapeutic Interventions
16 Principles and Techniques of Intra-aortic Balloon Pump
Counterpulsation
SHALE GORDON . . . . . . . . . . . . . . . . . . 171
17 Temporary and Permanent Pacemakers
AMAR S. KAPOOR ........ . 180
18 Automatic Implantable Defibrillator: Six-Year
Clinical Experience
ENRICO P. VELTRI, MORTON M. MOWER, and
MICHEL MIROWSKI . . . . . . . . . . . . . 193
19 Catheter Ablation Techniques for Treatment of
Cardiac Arrhythmias
MELVIN M. SCHEINMAN . . . . . . . . . . . . . . . . . 201
Contents xi
20 Interventional Pediatric Cardiac Catheterization
ZUHDI LABABIDI and IHAB ATTIA . . . . . . . 214
21 Balloon Aortic Valvuloplasty
BRICE LETA C 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 .......... . 267
24 Complex Coronary Angioplasty: The Outcome and Long-term
Effect of Angioplasty in Multivessel Coronary Disease and
Multiple Lesion Anigoplasty
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
xii Contents
31 Emergency Coronary Artery Bypass Surgery for Acute
Coronary Syndromes
SAMUEL L. SELINGER, RALPH BERG JR,
WILLIAM S. COLEMAN, JACK J. LEONARD, and
MARCUS A. DEWOOD. . . . . . . . . . . . . . . . . . . 377
32 Cardiac Transplantation
DAVIS DRINKWATER, LYNNE WARNER STEVENSON, and
HILLEL LAKS . . . . . . . . . . . . . . . . . . . . . . 387
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . 401