Volume 12 - Issue 6 - June, 2004

A Successful Suture-MediatedClosure Program: Turning YourLab Into a Profitable Entity

Purpose: To describe how the cardiac catheterization lab at Westchester Medical Center increased hospital revenues as a result of changing its groin management protocol.

Methods: In June 2000, Westchester Medical Center (WMC) implemented an arterial closure program. The primary endpoint of this program was to measure changes in the profitability of the cardiac catheterization lab (CCL) at WMC based upon implementation of a new groin management program. Profitability was measured by analysis of average Medicare reimbursement, average hospital cost for a catheterization proce



Mercy Medical Center's Experience: Early Ambulation post PCI with Use of Direct Thrombin Inhibitor, Bivalirudin

It is now widely accepted that early sheath removal after percutaneous coronary intervention (PCI) reduces femoral access site complications and leads to earlier ambulation, possibly earlier discharge, and improved patient satisfaction. Heparin-based anticoagulation therapy requires monitoring of coagulation status to determine readiness for sheath removal, due to the unpredictable nature of heparin. In an effort to increase quality of care for his patients undergoing PCI, as well as reduce the cost of resources in the cath lab, Dr. Sameer Mehta developed a time-based sheath removal proto



Distal Embolic Protection:A routine part of interventional procedures in the near futureCath Lab Digest talks with Donald S.

Why do you think that distal embolic protection has only relatively recently become a topic of interest in invasive cardiology?

In 1977, before Gruentzig did his first catheter-based angioplasties during bypass surgery, he evaluated for arterial debris by collecting the effluent from an artery dilated during surgery, and looking for embolic particles (none were seen). Clinically, when you look at the literature up through the mid-1990s, the only reports of embolization are in patients with thrombotic lesions, where a chunk of clot breaks off, embolizes and blocks a distal large bran



At the Heart: Cath Lab Planning Adapts to New Technology and Improved Diagnoses

Smaller, sleeker technologies in conjunction with increasingly sophisticated medical procedures have changed the face of cardiac catheterization labs.

Changing Spaces

In the above floor plans, which represent a health care provider both in the mid-1990’s and today, we can compare and contrast the way in which cardiac cath labs have changed over the past 10 years. While lab configuration has not changed radically, subtle differences in design can allow a lab to operate more efficiently.

Central to the design of modern cath labs is the shrinking of electronic e



Wake Forest University Baptist Medical Center

What is the size of your cath lab facility and number of staff members?

We have five suites with a total of 44 staff members, including technical and nursing staff, support personnel, and students. We only have two credentials in our lab: ARRT-registered radiologic technologist and registered nurse. We have staff members with varied years of experience, ranging from 2 to 30.

What type of procedures are performed at your facility?

We perform diagnostic right and left heart catheterizations, percutaneous coronary interventions, pediatric diagnostic catheterizations, pedi



Transvenous Annuloplasty for Ischemic Mitral Regurgitation

What is transvenous annuloplasty?

Transvenous annuloplasty, conceptually, is an alternative to conventional surgical annuloplasty. Currently, it is only an early development stage activity at multiple companies and centers; no products of this type have been permanently implanted in human subjects. Various approaches are being explored by Viacor and other investigators and companies. The objective is to substitute a percutaneous procedure for a surgical, bypass procedure in appropriate patients. The primary target for our device is ischemic mitral regurgitation.

Our device, the



Welcome to the team

It is two o’clock in the morning when your pager goes off. The sound of this obnoxious device awakens you from warmth of your bed. You fight the darkness, trying to put your thoughts together to partake in the normally simple task of dialing the phone. The hospital operator informs you that there is an acute MI in the ER that the cardiologist wants to cath emergently. As your heart races from the adrenaline that starts circulating and from being suddenly awakened, you manage to get dressed, get into your car, and drive yourself to the hospital within 30 minutes. As you enter the cath la