Exercise right heart catheterization for inferior vena cava obstruction: Confirming the hemodynamic significance of an anatomic lesion

2013 ◽  
Vol 83 (1) ◽  
pp. E105-E108 ◽  
Author(s):  
Mackram F. Eleid ◽  
Haraldur Bjarnason ◽  
Robert L. Frye ◽  
Rick A. Nishimura
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Inferior Vena Cava Obstruction

P2473Non-invasive assessment of central venous pressure in heart failure: comparing three-dimensional echocardiography and Swan-Ganz catheter

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Szymczyk ◽  
L J Paluszkiewicz ◽  
A Costard-Jaeckle ◽  
V Rudolph ◽  
J F Gummert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Three Dimensional ◽  
Vena Cava ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Cross Sectional ◽  
Dimensional Echocardiography

Abstract Background Assessing hemodynamics, in particular central venous pressure (CVP) is essential in heart failure diagnostics, leading individual therapy. Hereby, invasive measurement through Swan-Ganz right heart catheterization (RHC) is considered gold standard for patient evaluation, but catheterization implies risks of invasiveness including bleeding, infection, vessel and nerve injury, as well as patient discomfort. Non-invasive methods are warranted, but no alternative technique is validated yet. Two-dimensional echocardiography (2DE) is believed to be uncertain in this approach as vena cava often shows ellipse-shapes. Therefore, this study sought to investigate standardized and breathing corrected three-dimensional inferior vena cava echocardiography (3DE) to directly compare CVP with right heart catheterization. Methods and results We prospectively included 100 consecutive heart failure patients in this study (mean age 53±12 years, body mass index 27±5, New York Heart Association functional class 2.3±0.6, left ventricular ejection fraction 34.1±12.8%, brain natriuretic peptide 658.13±974.03, 76% male), all underwent Swan-Ganz right-heart catheterization and immediately both 2DE and 3DE (Philips EPIQ 7G) of inferior vena cava. From two-dimensional data the diameter of IVC was measured perpendicularly in long and short-axis. From 3DE data a cross-sectional image of IVC was reconstructed for both vertical and horizontal diameters of IVC as well as the area of IVC. Established 2DE images revealed mean vena cava sizes of 15.9±5.9 mm, while standardized cross-sectional breathing corrected 3DE images showed diameters of 19.8±7.8 mm in longitudinal axis and 15.74±7.8 in short axis. RHC mean CVP was 9.00±5.4 mmHg and correlation of CVP and 2DE measurements failed adequate correlation (2DE 95% CI 0.19–1.61; r=0.25; p=0.312). However, 3DE axis ratio assessment correlated well with invasive CVP and showed reproducible results (3DE 95% CI 0.26–0.69; r=0.89; p<0.01). This resulted for a CVP cut point of 10 mmHg in a 89% true negative and 50% true positive correct detection. Conclusions Standardized 3DE correlates well with invasive CVP while established 2DE usual care assessment does not show reliable CVP correlation. 3DE CVP assessment may represent a more feasible and easily applicable method for CVP measurement, including absence for risks of right heart catheterization. Further studies are ongoing to validate these findings in the future.

Inferior vena cava obstruction presenting as an abdominal mass.

Radiology ◽  
1983 ◽  
Vol 149 (1) ◽  
pp. 73-74 ◽  
Author(s):  
D R Voegeli ◽  
R P Lieberman ◽  
D R Yandow
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Abdominal Mass ◽  
Vena Cava ◽  
Inferior Vena Cava Obstruction

scholarly journals Isolated Marked Inferior Vena Cava Dilatation: Unusual Presentation or Underrecognized Common Phenomenon?

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Sneha R. Gadi ◽  
Benjamin K. Ruth ◽  
Alan Johnson ◽  
Sula Mazimba ◽  
Younghoon Kwon
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Unusual Presentation ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Common Phenomenon ◽  
Right Heart

Inferior vena cava (IVC) diameter and respirophasic variation are commonly used echocardiographic indices to estimate right atrial pressure. While dilatation of the IVC and reduced collapsibility have traditionally been associated with elevated right heart filling pressures, the significance of isolated IVC dilatation in the absence of raised filling pressures remains poorly understood. We present a case of an asymptomatic 28-year-old male incidentally found to have IVC dilatation, reduced inspiratory collapse, and normal right heart pressures.

Uncommon Findings in Tc-99m Macroaggregated Albumin Venography in Distal Inferior Vena Cava Obstruction

2006 ◽  
Vol 31 (10) ◽  
pp. 598-601 ◽  
Author(s):  
Efstratios Moralidis ◽  
Georgios Arsos ◽  
Apostolos Kambaroudis ◽  
Konstantinos Karakatsanis
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Obstruction ◽  
Macroaggregated Albumin

A Case of Inferior Vena Cava Obstruction Accompanying Pericardiacophrenic Collateral Circulation

1995 ◽  
Vol 42 (5) ◽  
pp. 787
Author(s):  
Jeong Su Kim ◽  
Seong Hoon Han ◽  
Young Soo Song ◽  
Woo Ki Jeon ◽  
Ho Kee Yum ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Collateral Circulation ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Obstruction

scholarly journals 1099 Constrictive pericarditis:a challenge in Cardiology

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Kairis ◽  
C Stefanidis ◽  
B Saxpekidis ◽  
C Petridis ◽  
L Mosialos ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pulmonary Artery ◽  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Cardiac Catheterization ◽  
Constrictive Pericarditis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Permanent Pacemaker ◽  
Right Heart

Abstract Funding Acknowledgements none A 50-year old woman had complained about dyspnea and leg swelling despite taking furosemide 80 mgr per day. Her past medical history had included radiation therapy for Hodgkin"s lymphoma, prosthetic heart valves (mechanical MV, AV- INR = 3,2) and permanent pacemaker. Also her coronary vessels were normal. On clinical examination she was non-febrile, the arterial pressure was 120/80mmHg,there was atrial fibrillation at 70 pulses/min at rest and oxygen saturation was 96%. The chest x-ray finding was left pleural effusion. The patient also had ascites. Kidney function was normal without proteinuria. The diagnostic paracentesis and biochemical analysis of ascitic fluid was indicative of transudative fluid.Cytologic analysis was negative for malignancy. Moreover,needle biopsy specimen was subjected to histopathology,which was negative for malignancy. Echocardiography had revealed normal size and function of left ventricle ( LV = 46mm-EF = 60%). The mechanical valves had normal function, without paravalvular leak or masses. Also right ventricle was normal. The pulmonary artery pressure measured by echocardiography was in the normal range (RVSP = 35mmHg), but the inferior vena cava was dilated.There were also dilated hepatic veins and hepatic vein flow reversal.There was variation&gt; 25% in triscupid inflow with respiration. TEE had confirmed the findings of transthoracic echo with regard of prosthetic valves. CT of chest and abdomen findings were no pathologic lymphadenopathy,no pulmonary embolism and absence of tumor compressing inferior vena cava. Chest CT scan had demonstrated pericardium thickening,indicative of constrictive pericarditis. CMR was not performed because of permanent pacemaker. The final step in diagnostic algorithm was cardiac catheterization: a)the pulmonary artery systolic pressure measured during right heart catheterization was 35mmHg. b)dip & plateau’ pattern or ‘square root sign of right ventricle, i.e. pattern of accentuated early dip in diastolic pressure, followed by plateauing in mid-late diastole. c)prominent y wave of right atrium- absent x wave because of AF. d)left ventriculography was not performed because of mechanical aortic valve. At the end constrictive pericarditis was confirmed by the surgical report. According to ESC guidelines a diagnosis of constrictive pericarditis is based on the association of signs and symptoms of right heart failure and impaired diastolic filling due to pericardial constriction by one or more imaging methods, including echocardiography, CT, CMR, and cardiac catheterization. However,the most important step is the suspicion of constrictive pericarditis, especially in patients with history of radiation therapy and heart surgery. Abstract 1099 Figure.

Inferior Vena Cava Obstruction After Pectus Excavatum Repair

2009 ◽  
Vol 23 (4) ◽  
pp. 515-517 ◽  
Author(s):  
Bryan Harris ◽  
Gerald A. Bushman ◽  
Laura A. Hastings
Keyword(s):  
Inferior Vena Cava ◽  
Pectus Excavatum ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Obstruction
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