Catheterization laboratory

Short description: Hospital examination room

Catheterization laboratory

Medical diagnostics

German cardiac catheterization laboratory

Purpose| visualize the arteries and chambers of the heart

A catheterization laboratory, commonly referred to as a cath lab, is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found.

## Contents

* 1 Equipment
* 2 Staff
* 2.1 Medical practitioner (interventional cardiologist/electrophysiologist)
* 2.2 Cardiac physiologist
* 3 Procedures
* 4 See also
* 5 References
* 6 External links

## Equipment

Most catheterization laboratories are "single plane" facilities, those that have a single X-ray generator source and an X-ray image intensifier for fluoroscopic imaging.[1] Older cath labs used cine film to record the information obtained, but since 2000, most new facilities are digital. The latest digital cath labs are biplane (have two X-ray sources) and use flat panel detectors.[2]

## Staff

Cardiac catheterization laboratories are usually staffed by a multidisciplinary team. This may include a medical practitioner (normally either a consultant cardiologist or radiologist), cardiac physiologist, radiographer and nurse.[3][4]

### Medical practitioner (interventional cardiologist/electrophysiologist)

The consultant cardiologist is responsible for gaining arterial access, inserting a sheath into either the radial or femoral artery, passing a wire and catheter into the coronary artery and selectively injecting contrast media into the coronary arteries. They then interpret the images taken to ascertain where the narrowed or blocked artery has the problem. They use a variety of techniques and imaging tools to measure the size of things such as balloons and stents.

### Cardiac physiologist

Cardiac physiologists usually set up what is known as a transducer to monitor pressure in the arteries. They also have a live view of the patients ECG so they can tell whether or not there is a problem caused by the insertion of the catheter into the heart to the electrical pathways.[5][6] The physiologist will also set up a temporary pacemaker if the procedure is an angioplasty or a percutaneous coronary intervention (PCI). Finally, they also set up defibrillators on to the patient for emergency use if needed. In some locations, some of these responsibilities may be carried out by other personnel, such as trained nurses or technologists.[7]

## Procedures

Main article: Medicine:Cardiac catheterization

Cardiac catheterization is a general term for a group of procedures that are performed in the cath lab, such as coronary angiography. Once a catheter is in place, it can be used to perform a number of procedures including angioplasty, PCI (percutaneous coronary intervention) angiography, transcatheter aortic valve replacement, balloon septostomy, and an electrophysiology study or catheter ablation. Devices such as pacemakers may be fitted or rotablation to remove plaque can be performed.[8][9]

## See also

* Cardiology

## References

1. ↑ Hertrich, Peter (2005-07-11) (in en). Practical Radiography. John Wiley & Sons. p. 96. ISBN 9783895782107. https://books.google.com/books?id=GSd0IqSt3bsC&pg=PA94.
2. ↑ Sievert, Horst; Qureshi, Shakeel; Wilson, Neil; Hijazi, Ziyad M. (2007-03-20) (in en). Percutaneous Interventions for Congenital Heart Disease. CRC Press. p. 7. ISBN 9780203018262. https://books.google.com/books?id=Dq_lqgqP-REC&pg=PA7.
3. ↑ Banning, Adrian P; Baumbach, Andreas; Blackman, Dan; Curzen, Nick; Devadathan, Sen; Fraser, Douglas; Ludman, Peter; Norell, Micheal et al. (3 June 2015). "Percutaneous coronary intervention in the UK: recommendations for good practice 2015". Heart 101 (Suppl 3): 1–13. doi:10.1136/heartjnl-2015-307821. PMID 26041756.
4. ↑ Naidu, Srihari S.; Aronow, Herbert D.; Box, Lyndon C.; Duffy, Peter L.; Kolansky, Daniel M.; Kupfer, Joel M.; Latif, Faisal; Mulukutla, Suresh R. et al. (September 2016). "SCAI expert consensus statement: 2016 best practices in the cardiac catheterization laboratory" (in en). Catheterization and Cardiovascular Interventions 88 (3): 407–423. doi:10.1002/ccd.26551. PMID 27137680.
5. ↑ "Emergency angioplasty: inside the catheter lab" (in en). https://www.bhf.org.uk/heart-matters-magazine/medical/primary-angioplasty/radiographer. Retrieved 2 January 2018.
6. ↑ "What does a cardiac physiologist do?" (in en). https://www.bhf.org.uk/heart-matters-magazine/medical/a-medical-who-is-who/cardiac-physiologist. Retrieved 2 January 2018.
7. ↑ Watson, Sandy; Gorski, Kenneth (2010). "Cath Lab Staff Duties" (in en). Invasive Cardiology: A Manual for Cath Lab Personnel. Jones & Bartlett Learning. pp. 119–129. ISBN 9780763764685. https://books.google.com/books?id=eDWH-HFJEjsC&pg=PA119.
8. ↑ "What to expect in a cath lab" (in en). https://www.bhf.org.uk/heart-matters-magazine/medical/what-to-expect-in-a-cath-lab. Retrieved 20 April 2017.
9. ↑ Kobus, Richard L. (2008-04-25). "Interventional Departments" (in en). Building Type Basics for Healthcare Facilities. John Wiley & Sons. p. 67. ISBN 9780470135419. https://books.google.com/books?id=TBXMA8ndUXoC&pg=PA67.

## External links

* MedlinePlus Medical Encyclopedia: Cardiac catheterization
* Observational study on cases of brain and neck tumors among cath lab operators

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Surgery and other procedures involving the heart (ICD-9-CM V3 35–37+89.4+99.6, ICD-10-PCS 02)

Surgery and IC|

| Heart valves
and septa|

* Valve repair
* Valvulotomy
* Mitral valve repair
* Valvuloplasty
* aortic
* mitral
* Valve replacement
* Aortic valve repair
* Aortic valve replacement
* Ross procedure
* Percutaneous aortic valve replacement
* Mitral valve replacement
* Percutaneous pulmonary valve implantation

production of septal defect in heart
enlargement of existing septal defect

Atrial septostomy
Balloon septostomy
creation of septal defect in heart

Blalock–Hanlon procedure

shunt from heart chamber to blood vessel
atrium to pulmonary artery

Fontan procedure
left ventricle to aorta

Rastelli procedure
right ventricle to pulmonary artery

Sano shunt

compound procedures
for transposition of the great vessels

Arterial switch operation
Mustard procedure
Senning procedure
for univentricular defect

Norwood procedure
Kawashima procedure

shunt from blood vessel to blood vessel
systemic circulation to pulmonary artery shunt

Blalock–Taussig shunt
SVC to the right PA

Glenn procedure

|

Cardiac vessels|

CHD
Angioplasty
Bypass/Coronary artery bypass

MIDCAB
Off-pump CAB
TECAB

Coronary stent
Bare-metal stent
Drug-eluting stent

* Bentall procedure
* Valve-sparing aortic root replacement

* LeCompte maneuver

Other|

Pericardium
Pericardiocentesis
Pericardial window
Pericardiectomy

Myocardium
Cardiomyoplasty
Dor procedure
Septal myectomy
Ventricular reduction
Alcohol septal ablation

Conduction system
Maze procedure

Cox maze and minimaze
Catheter ablation

Cryoablation
Radiofrequency ablation
Pacemaker insertion

* Left atrial appendage occlusion
* Cardiotomy
* Heart transplantation

Diagnostic
tests and
procedures|

Electrophysiology
Electrocardiography

Vectorcardiography
Holter monitor
Implantable loop recorder
Cardiac stress test

Bruce protocol
Electrophysiology study

Cardiac imaging
Angiocardiography
Echocardiography

TTE
TEE
Myocardial perfusion imaging
Cardiovascular MRI
Ventriculography

Radionuclide ventriculography
Cardiac catheterization/Coronary catheterization
Cardiac CT
Cardiac PET

sound
Phonocardiogram

Function tests|

* Impedance cardiography
* Ballistocardiography
* Cardiotocography

Pacing|

* Cardioversion
* Transcutaneous pacing

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