Cardiac Catheterisation Lancashire & South Cumbria Cardiac Network

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

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

Techniques - LHC Sones –Brachial artery ‘cut-down’ –Bed rest not required Judkins –Seldinger method –Vessel/nerve damage less likely –Femoral or radial

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

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

Catheter characteristics List as many characteristics as possible

Instrumentation system Catheter Pressure line Transducer Pressure monitoring system

System criteria Stability Sensitivity Adequate frequency response

Pressure line & transducer kit Heparinised 0.9% saline Maintain sterility fluid filled – air free Zero & calibration Prevents backflow of blood

Transducer Mechanical to electrical Strain gauge – wheatstone bridge technology Strain defined as fractional change in length RESISTANCE  LENGTH

Vent to air Pressure

Electrical circuit V R1R3 R4R2 Resistances are equal – no current flows R1 & R2  and R3 & R4  - current flows

Arrangement of the equipment Name as many reference points as possible

Pressure ranges Left sided pressures what range? Right sided pressures what range?

calibration Ensure scale and linked sensitivity is correct zero calibration INCORRECT ADJUSTED

Damping Reduction in amplitude & frequency of pressure waveform UNDERDAMPED OVERDAMPED CORRECT

Causes of Damping List the reasons for damping during cardiac catheterisation (1) (2) (3)

Overshoot & Sensitivity Caused by compliance characteristics of the pressure system Inclusion of ROSE will eliminate overshoot ROSE ?

ANY QUESTIONS?