1. Cardiac Catheterisation Lancashire & South Cumbria Cardiac Network

2. 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

3. 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

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

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

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

7. Catheter characteristics List as many characteristics as possible

8. Instrumentation system Catheter Pressure line Transducer Pressure monitoring system

9. System criteria Stability Sensitivity Adequate frequency response

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

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

12. Vent to air Pressure

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

14. Arrangement of the equipment Name as many reference points as possible

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

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

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

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

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

20. ANY QUESTIONS?