CATH LAB
Its best and main use is for the detection and identification of irregularities within the heart and its vasculature, the aorta, or the vena cava, as well as for defining the size or severity of lesions and for the complete evaluation of a patient with known or suspected heart disease. It is also used in the diagnosis of disorders such as reduced left ventricular function, valve dysfunction, pulmonary vascular disease and congenital anomalies and is also used for pacemaker lead placement.
Basic components
a. C-Arm
b. Pressure injector
c. Dye injector
d. Hemodynamic monitor
e. Review station
f. Diagnostic catheter
g. Guide catheter
h. Guide wires
i. Stent
j. Angioplasty balloon
Working principle
The basic cathlab recording system consists of a computer console and a chart recorder, which typically reside in a control room.
A slave scope and patient interface modules reside in the cathlab. All the systems are multichannel and display and record up to 32 traces of information from the patient.
Connecting the cathlab monitor/recorder to the computer automatically calculates most of the hemodynamic parameters.
The parameters that are automatically derived typically include cardiac output, pressure gradients, valve areas, shunt flows, vascular resistance, diastolic filling period, systolic ejection period, work, and preejection period.
These values ​​are stored chronologically along with other important events that occurred during catheterization, and are printed in report form at the conclusion of the procedure.
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It is possible to interface with the CathLab imaging system to provide X-ray image visualization on a physiological monitor. Before catheterization, a full 12-lead electrocardiogram (ECG) is usually performed to obtain baseline values.
This preliminary study can also disclose unsuspected abnormalities. During the procedure, continuous arterial pressure can be monitored directly.
For right-heart catheterization (RHC), the catheter is introduced into a vein in the arm, external jugular vein, or femoral vein in the groin and then manipulated into the right atrium of the heart under direct observation using fluoroscopy.
The catheter is then passed through the right ventricle and lodged in the pulmonary artery. In left-heart catheterization, which is less common, the catheter is introduced into an artery in the arm or into the femoral artery and maneuvered through the aortic valve and into the left ventricle.
Pressure measurements from the pulmonary artery, including pulmonary artery wedge pressure, provide one reliable index of left ventricular function.
Pressure-gradient recordings can be made by drawing the catheter back through the heart chambers gradients from one chamber to another indicate the site of stenosis or obstruction.
Pressure measurements taken in the right atrium determine central venous pressure. Intracardiac pressure measurements are taken by one of two methods.
1. Fluid-filled catheter
2. Blood pressure transducer
The fluid-filled lumen of the catheter transfers pressure fluctuations from the open distal end of the catheter inside the patient to a transducer at the proximal end outside the patient, which converts the mechanical force of the applied pressure into electrical signals that are proportional to There are pressures. These signals are then transmitted to a pressure amplifier in the recording system.
Generally, a larger lumen allows for a better pressure reading.
The second method uses a transducer in the catheter tip to measure pressure fluctuations.
The status of the myocardium can be evaluated by measuring pulmonary and systemic blood flows to determine cardiac output.
The most widely used method is the thermal dilution technique in which a chilled or room-temperature saline solution is injected through the catheter into the right atrium; its temperature is measured by a thermistor at the distal end of the catheter, located in the pulmonary artery.
The temperature change correlates with the blood flow through the heart.
ECG/His amplifiers receive signals from electrode catheters placed inside the various chambers of the heart and from electrodes on the chest.
Studies of the bundle of His provide an assessment of the heart’s electrical conduction system.
Use of cath and surgery
A cardiac catheter lab, also known as a “cardiac cath lab”, is a specialized area in a hospital where doctors perform minimally invasive tests and advanced cardiac procedures to diagnose and treat heart disease.
A cath lab is a procedural hospital room where minimally invasive tests and procedures are performed for the diagnosis and treatment of heart disease. Procedures performed in a cath lab involve a small, flexible tube called a catheter.
In this procedure, doctors use a long, thin tube called a catheter to access the heart or other structures. The catheter is inserted into a small incision in the body, usually in your upper thigh, arm, or neck, and threaded through the blood vessels.
Catheterization can often prevent the need for more invasive surgery.
Pain during this process
The patient may feel pressure during the procedure, but should not feel any pain. From there, a variety of instruments can be placed on the tip of the catheter.
These devices are given to your doctor to measure the blood pressure in each chamber of the heart and in the blood vessels attached to the heart.
Risks of catheterization
Like most procedures performed on the heart and blood vessels, cardiac catheterization has some risks. However, major complications are rare/non-existent.
1. bleeding.
2. blood clots.
3. getting hurt.
4. Damage to the artery, heart, or area where the catheter was inserted.
5. heart attack.
6. infection.
7. irregular heart rhythm (arrhythmia).
8. Kidney damage.
These are one of the fewest complications seen after cardiac catheterization procedures. Hematomas usually form after poorly controlled hemostasis post sheath removal.