CATHLAB PROCEDURES

BY
Sadashiv
&
Sajini
 CATHLAB
A catheterization laboratory or cath lab is an
examination room in a hospital or clinic with diagnostic
imaging equipment used to support the catheterization
procedure.
CARDIAC CATHETERISATION
Cardiac catheterization is the insertion and
passage of small plastic tubes (catheters) into arteries &
veins up to the heart to obtain X-ray pictures of coronary
arteries & cardiac chambers, as well as to measure pressure
in the heart (intra cardiac hemodynamics).
This is done for both investigational and
interventional purposes
 INDICATIONS
• Suspected or known coronary artery
disease
• New onset angina
• Unstable angina
• Evaluation before a major surgical
procedure
• Silent ischemia
• Post ETT (Exercise treadmill test)
• Atypical chest pain or coronary spasm
• Myocardial infarction
• Unstable angina post infarction
• Failed thrombolysis
• Shock
• Mechanical complication (VSD, rupture of wall or
papillary muscle)
• Sudden cardio vascular death
• Valvular heart disease
• Congenital heart disease( before anticipated corrective
surgery)
• Aortic dissection
• Pericardial constriction or tamponade
• cardiomyopathy
• Initial & follow up assessment for heart transplant
 CONTRA INDICATIONS
• Absolute contra Indications
• Inadequate equipment or catheterization facility
• Relative contra Indications
• Uncontrolled congestive heart failure
• High BP
• Arrhythmias
• Recent CVA(< 1 month)
• Infection ( Fever)
• Electrolyte imbalance
• Acute GI bleeding or Anemia
• Pregnancy
• Anticoagulation or known uncontrolled bleeding diathesis
• Uncooperative patient
• Medication intoxication ( e.g, digitalis, phenothiazine)
 COMPLICATIONS
• Myocardial infarction
• CVA
• Serious arrhythmias
• Ventricular Tachycardia
• Ventricular fibrillation & flutter
• Atrial fibrillation & flutter
• Supra Ventricular Tachycardia
• Heart block
• Asystole
• Vascular injury
• Hemorrhage ( local, retroperitoneal, pelvic)
• Pseudo aneurysm
• Thrombosis / embolus / air embolus
• Aortic dissection
• Cardiac perforation, tamponade
• Contrast reaction / anaphylaxis / nephrotoxicity
• Infection
• CHF
• Vasovagal reaction
• Death
 DIAGNOSTIC PROCEDURES

Coronary angiography

Coronary angiography with graft study

Right heart catheterization

Peripheral angiography

Carotid angiography

Renal angiography

Cerebral angiography

Electro physiologic study
 THERAPEUTIC PROCEDIRES

Temporary pacemaker implantation

Permanent pacemaker implantation

Single chamber

Dual chamber

Bi ventricular

Radio frequency ablation

I C D implantation

VALVULOPLASTY

BMV

PTMC

Pulmonary valvuloplasty

Aortic vavuloplasty

ANGIOPLASTY

Coronary plain balloon angioplasty

Coronary angioplasty with stent

Rotablator angioplasty

Peripheral angioplasty

Carotid angioplasty
Other interventional procedures.....
• Embolization with coil or gel
• Intra coronary trombolysis
• I V C filter implantation
• PTSMA
• ASD device closure
• VSD device closure
• PDA closure( device or Coil)
• IABP Insertion
• Pericardial Tapping
 PRE CATH CHECK LIST
• Patient name & UHID
• Patient ID band
• IV line
• Consent
• Pre cath blood investigations
• ECG/ECHO/X-RAY
• Finance Clearance
• Check for Dentures & contact lens
• Angiosite preparation
• Nil per oral
• Patient height & weight
• Pre medication
CORONARY ANGIOGRAPHY
CATHETERS & SHEATH USED FOR CAG
CORONARY ANGIOPLASTY
CORONARY ANGIOPLASTY WITH STENT
ASD device closure
TEMPORARY PULSE GENERATOR & PACING LEAD
PERMANENT PACEMAKER
MITRAL VULVULOPALSTY
CONCLUSION