Volume 19 - Issue 4 - April 2011

Maury Regional Medical Center

Can you tell us about your cath lab?

Maury Regional Medical Center (MRMC) is a 250-bed facility serving an eight-county region in middle Tennessee. Maury Regional Medical Center Outpatient Cardiology includes two cardiac cath labs, both of which are capable of performing radiologic procedures and implantable rhythm management devices. The lab also includes a 5-bed holding area located within the department.



Use of the Impella 2.5 Device With Multi-Vessel Stenting in Severe Peripheral Artery and Left Main Disease

Abstract: Percutaneous transcatheter coronary angioplasty (PTCA) and stenting to the left main coronary artery or to multiple vessels are options in patients who are poor candidates for coronary artery bypass graft surgery (CABG). However, it is associated with high mortality and morbidity, and is considered to be high-risk percutaneous coronary intervention (PCI). These patients can develop fatal arrhythmias, hemodynamic instability or cardiogenic shock due to ischemia to the viable myocardium by balloon dilatation and catheter manipulations.



STEMI Recommendations from Thought Leaders at LUMEN 2011


LUMEN (www.lumenami.com), a meeting focusing on both the STEMI process and procedure, took place February 24-26 in Miami, Florida.

Transradial access, left ventricular support devices, and cell therapy are the most cutting-edge developments in the treatment of ST-elevation myocardial infarction (STEMI) today, emphasized LUMEN course director Dr. Sameer Mehta in his opening remarks. Over 200 LUMEN attendees experienced a full day of transradial access education, and reports on left ventricular assist devices (LVAD) and cell therapy research by leading physicians, allowing for in-depth immersion in these topics.



Establishing a “Quality” Program for PCI in Your Lab


Why do we talk so much and so often about quality?

It’s simple. We want the best for our patients. We want good care from top-rated physicians doing their work in top-rated facilities, with the most experienced and skilled cath lab staff, and with the best outcomes possible. I want my stenting performed in the best place and by the best physician, and likely, so do you. But how do we know what is the best place or even an acceptable place (or physician)? We have all read the papers about unnecessary procedures, including stents, performed in some places that were possibly not the best. Differences in “quality” are the top of the list of complaints about medical care.



Measuring the Score: Understanding the Parsonnet and EuroSCORES for Guidance Proceeding With Unprotected Left Main PCI in a High-Risk, Non-Surgical Candidate

Percutaneous coronary intervention (PCI) has emerged as a viable treatment option for left main coronary artery (LMCA) disease. Data show that PCI is particularly safe and effective in low-risk patients, especially in those with angiographically favorable lesions.1,2 The 2009 American College of Cardiology (ACC)/American Heart Association (AHA)/Society for Cardiovascular Angiography and Interventions (SCAI) focused PCI guidelines state that LMCA stenting can be considered in patients with anatomic conditions that are associated with a low risk of procedural complications and clinical characteristics that may increase the risk of adverse surgical outcomes (class IIb).3



What Do You Think?

Email your response to cathlabdigest@aol.com, or post it online at www.facebook.com/cathlabdigest.

Re: Manual sheath removal and post care
I was wondering if there is any educational information you could recommend that I could share with my ICU and Telemetry units to help them to be more proficient in this area.

Thank you,
Margaret Frank
Email: robertfrank@citlink.net
Cc: cathlabdigest@aol.com



IVUS-Guided Vena Cava Filter Placement: Technique and Clinical Decision Algorithm

Although contrast venography is the standard imaging method for vena cava filter insertion, intravascular ultrasound (IVUS) is a safe and effective alternative that allows for bedside placement options, and is especially advantageous for critically ill patients.1–9 Depending on the clinical situation and the filter type used, either a single- or dual-puncture technique can be employed. Feasibility of one technique over the other depends on understanding filter design and delivery catheter features. The following will describe the essential steps for IVUS-guided vena cava filter placement, including preprocedural imaging, single access, and dual-access techniques. A proposed clinical decision algorithm for IVUS-guided vena cava placement, established according to evidence-based guidelines, will be reviewed.



Integrating Education into a Clinical Ladder for Cardiac Catheterization Clinical Professionals

Continuing education is vital to not only the success of a service line program, but to the clinician(s) providing care. Many cardiovascular programs across the United States have either considered or implemented a tiered approach through a clinical ladder. More often than not, cardiovascular service line staff is on the front lines of care, putting out fires throughout the day that require clinical and operational skills, as well as the ability to remain composed and confident about the care they are providing.



News from the Society of Invasive Cardiovascular Professionals (SICP)

A Letter from the SICP Director:

Register Today! The SICP Annual Meeting is July 28-30, 2011, in Boston, Massachusetts

Registration is open and available online at www.sicp.com. Please make your plans to participate in this much-anticipated meeting. Topics include: Exploration of New Techniques, Case Studies and Student Abstracts, Skills & Lab, Wet Lab, Structural Heart Repair, as well as the SICP’s RCIS Signature Review Course. Along with the Educators Committee breakout session (see below), we hope to have a Manager’s Retreat breakout session. We continue to value member input, so if you would like to participate, please contact us at membership@sicp.com.



News

Corindus Announces First Robotic-Assisted PCI Procedures in CorPath® PRECISE Clinical Trial

Study underway to evaluate robotic-assisted placement of coronary guidewires and stent/balloon catheters

Corindus Vascular Robotics, a developer of precision vascular robotics, announced that the clinical trial of its CorPath® PRECISE (Percutaneous Robotic-Enhanced Coronary Intervention Study) has begun. The first percutaneous coronary intervention (PCI) procedures using the CorPath 200 System were performed at NewYork-Presbyterian Hospital/Columbia University Medical Center in New York and St. Elizabeth’s Medical Center in Boston.



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