Cardiac Catheterisation

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Cardiac Catheterisation

• Lancashire South Cumbria Cardiac Network

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• Involves the introduction of hollow shaped
  plastic tubes into the chambers of the heart and
  surrounding vessels
• Under x-ray control
• Aim to diagnose treat heart disease

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Procedures

• Angiography injection radio-opaque dye to
  establish blood flow, contractility and establish
  anatomical stenosis and abnormalities
• Intra-cardiac pressure recordings to establish
  pressure status within individual
  chambers/vessels
• Oximetry to establish level of oxygen
  saturation across chambers/vessels
• Cardiac output measurements to establish
  cardiac output and calculation of shunts and
  vascular resistances

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Techniques - LHC

• Sones
• Brachial artery cut-down
• Bed rest not required
• Judkins
• Seldinger method
• Vessel/nerve damage less likely
• Femoral or radial

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Technicians Role

• What are the common duties carried out by the
  technician for diagnostic/intervention procedures
  within the catheter laboratory?

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Catheter definitions

• Catheter
• French size
• Lumen
• Length
• Guide wire
• Bolus
• Flow
• Radio-opaque
• Radio-translucent

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Catheter characteristics

• List as many characteristics as possible

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Instrumentation system

• Catheter
• Pressure line
• Transducer
• Pressure monitoring system

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System criteria

• Stability
• Sensitivity
• Adequate frequency response

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Pressure line transducer kit

• Heparinised 0.9 saline
• Maintain sterility
• fluid filled air free
• Zero calibration
• Prevents backflow of blood

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Transducer

• Mechanical to electrical
• Strain gauge wheatstone bridge technology
• Strain defined as fractional change in
  length RESISTANCE ? LENGTH

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Pressure
Vent to air
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Electrical circuit
R1
R3
R4
R2
V
Resistances are equal no current flows
R1 R2 ? and R3 R4 ? -
current flows
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Arrangement of the equipment

• Name as many reference points as possible

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Pressure ranges

• Left sided pressures what range?
• Right sided pressures what range?

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calibration

• Ensure scale and linked sensitivity is correct

calibration
zero
INCORRECT ADJUSTED
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Damping

• Reduction in amplitude frequency of pressure
  waveform

UNDERDAMPED OVERDAMPED CORRECT
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Causes of Damping

• List the reasons for damping during cardiac
  catheterisation
• (1)
• (2)
• (3)

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Overshoot Sensitivity

• Caused by compliance characteristics of the
  pressure system
• Inclusion of ROSE will eliminate overshoot
• ROSE ?

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• ANY QUESTIONS?