Cardiac Catheterization Handbook

1. INTRODUCTION TO THE CATHETERIZATION LABORATORY- Indications for Cardiac Catheterization- Contraindications- Complications and Risks- Catheterization Laboratory Data- Preparation of the Patient- Special Preparations- The Team Approach to Cardiac Catheterization- Equipment in the Catheterization Laboratory- Training Requirements- Environmental Safety in the Catheterization Laboratory2. ARTERIAL AND VENOUS ACCESS PERCUTANEOUS FEMORAL - The Arm Approach- Use of Heparin during Cardiac Catheterization- Problems of Vascular Access- Common Problems in Accessing and Cannulating Coronary Arteries and Grafts- Arterial and Venous Access: Nurse/Technician Viewpoints- Equipment and Instruments Used for Access3. HEMODYNAMIC DATA- Pressure Waves in the Heart- Right and Left Heart Catheterization- Computations for Hemodynamic Measurements- Computations of Valve Area from Pressure Gradients and Cardiac Output- Examples of Aortic and Mitral Valve Area Calculations- Use of Valve Resistance for Aortic Stenosis- Measurement of Cardiac Output- Intracardiac Shunts- Equipment Used for Hemodynamic Study- Hemodynamic Recording Techniques- Hemodynamic Examples and Artifacts- Electrocardiography in the Cardiac Catheterization Laboratory4. ANGIOGRAPHIC DATA- Section I: Cardiac Angiography- Coronary Arteriography- Problems and Solutions in the Interpretation of Coronary Angiograms- Ventriculography- Section II: Other Cardiovascular Angiographic Studies- Ascending Aortography- Abdominal Aortography- Pulmonary Angiography- Periperal Vascular Angiography- Section III: The X-Ray Image- Generation of the X-Ray Image- Digital Angiography- Radiation Safety- Section IV: Angiographic Equipment- Injectors and Contrast Materials- Angiographic Catheters- Medications Used in Coronary Angiography- Pacemakers5. ELECTROPHYSIOLOGIC STUDIES AND ABALTION TECHNIQUES- Technical Aspects- Procedures- Utility of EPS of Specific Diagnosis- Catheter Ablation6. RESEARCH TECHNIQUES- Quantitative Coronary Angiography and Ventriculography- Myocardial Blood Flow- Myocardial Metabolism- Coronary Sinus Catheterization- Doppler Coronary Flow Velocity Techniques- Combined Hemodynamic and Echocardiographic Methodologies- High-Fidelity Micromanometer-Tip Pressure Measurements- Physiologic Maneuvers in the Catheterization Laboratory7. SPECIAL TECHNIQUES- Transseptal Heart Catheterization- Direct Transthoracic LV Puncture- Endomyocardial Biopsy- Coronary Sinus (CS) Catheterization- Intravascular Foreign Body Retrieval- Transluminal Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy- Special Conditions8. HIGH-RISK CARDIAC CATHETERIZATION- The High-Risk Patient- Incidence of Complications in the High-Risk Patient- Management of Arrhythmias in High-Risk PatientsCardiac Support Devices9. INTERVENTIONAL TECHNIQUES- Percutaneous Coronary Interventions (PCI)- Valvuloplasty10. DOCUMENTATION IN THE CARDIAC CATHETERIZATION LABORATORY- Healthcare Quality Standards to Reduce Medical Malpractice- The Medical Record: General Points- Minimum Documentation in the Catheterization Laboratory- Charting Recommendations for Outpatient Catheterization - Documentation for Medical Treatment Problems or Complications: Events Requiring an Incident ReportEquipment Failure