The Cardiac Catheterization Handbook

Morton J. Kern, MD, FSCAI, FAHA, FACC, Professor de Medicina da Universidade da California, Irvine, Orange, California; Chief of Medicine, Health Care System Veterans Long Beach, Long Beach, California;

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 Laboratory 2.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 Access 3.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 Laboratory 4.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 - Pacemakers 5.ELECTROPHYSIOLOGIC STUDIES AND ABALTION TECHNIQUES - Technical Aspects - Procedures - Utility of EPS of Specific Diagnosis - Catheter Ablation 6.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 Laboratory 7.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 Conditions 8.HIGH-RISK CARDIAC CATHETERIZATION - The High-Risk Patient - Incidence of Complications in the High-Risk Patient - Management of Arrhythmias in High-Risk Patients Cardiac Support Devices 9.INTERVENTIONAL TECHNIQUES - Percutaneous Coronary Interventions (PCI) - Valvuloplasty 10.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 Report Equipment Failure