Volume 15 - Issue 3 - March, 2007
Magnetically Supported PCI: Success after failed surgery and conventional PCI
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The System
The Niobe® II magnetic navigation system (MNS: Stereotaxis, St Louis, Missouri) has two external magnets that produce a 15-cm uniform magnetic field. Through computer-controlled magnet movements, the magnetic field can be directed in all planes. When the field is changed, the deflection of the magnet at the wire tip also changes, resulting in reproducibly precise steering. The system has an adjustable touch screen at the lab table that is the interface between the operator and the MNS (Figure 1).
The current system has three main advant
Tips to Improve Door-to-Balloon Time to < 90 Minutes:Life in the real world
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Treatment and care of these patients has improved significantly over the past decade, which has resulted in a decline in mortality and morbidity.
The AHA and the American College of Cardiology (ACC)2 formed a task force to develop guidelines and performance measures that would address the care of patients presenting with a STEMI or NSTEMI.3 The task force published their guidelines in January 2006.
On July 1, 2006, the ACC/AHA set a goal to reduce door-to-inflation time from <120 minutes to <90 minutes. Meeting this goal saves heart muscle, reduces infarct
Radiation Exposure in Cardiology Testing: How much is too much?
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Daily non-occupational exposure:
It is well-known that there is naturally occurring background radiation exposure for everyone, everywhere. The average person in the United States receives an approximate 3 mSv per year from naturally occurring radioactive background activity from land and atmospheric sources. For example, for those individuals with atmospheric exposure at high elevation locations such as New Mexico and Colorado, there is an increase of approximately 1.5 mSv more per year than at sea level. Individuals flying on commercial airplanes on coast-to-coast round trip fli
Ask the Clinical Instructor:A Q&A column for those new to the cath lab
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It depends on a lot of things. One of the things that matters is this: is your lab an open lab or a closed lab? This means are vendors allowed in the rooms or not? This is determined by the managers and/or physician director. Some places do not allow vendors in the lab. They may feel as though this is influencing decisions and would rather not have them there. Some labs (open labs) may ask for the vendors in the room in order to have someone there who has specific product information to help them make decisions about the equipment they are using and what is best for the patient.
One of
Advancing the Field of Coronary Intervention: Magnetic Guidewire Navigation
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Why Do We Need Such Technology?
While the currently available guide catheters, highly specialized guidewires, and transit catheters have allowed operators to gain access to distal vasculature not reachable five years ago, we still run into the case where the operator has exhausted all of the available wires and tricks without success. In case you are having difficulty remembering the last time this happened, just check the lab procedure log for the last case with 62 minutes of fluoroscopy time and more than 300 cc of contrast delivered!
The American College of Cardiology/America
The Ten-Minute Interview with: Belinda Trollinger, RN, RCIS
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My name is Belinda Trollinger, RN, RCIS. I have been an RN for 23 years. I work in the Cardiovascular Electrophysiology Lab at Baptist Hospital in Pensacola, Florida. I am one of the charter members of the Emerald Coast Chapter of the SICP. I recently became the Publications Committee Chair for the Society of Invasive Cardiovascular Professionals.
Why did you choose to work in the invasive cardiovascular field?
I wanted to work where I could see these wonderful procedures which generate information, open vessels, and can solve the mechanical issues in cardiovascular care. I lea
Communicating the Benefits of Drug-Eluting Stents to Patients
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What do you first tell a patient who will require treatment for coronary artery disease (CAD)?
I like to begin with a discussion of the benefits and risks of each treatment option so that we can together decide if a catheter-based therapy is ideal for the individual. Once the patient and I have determined that catheterization is the best option, I outline the available treatments, including the various types of stents. Invariably, this leads to a discussion of bare-metal stents versus drug-eluting stents, and at this time I make clear the benefits and risks associated with each of th
Hemodynamics is a 12-Letter Word!An intro to the basics.Part I: Basics with Wiggers
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There are other shortcomings in today’s advanced hemodynamic systems. Marking the correct points on the waveforms is one example, but the purpose of this article is not to point out all these issues, but to aid in educating cath lab staff in the basics of hemodynamics. In order to operate the hemodynamic systems, it is essential to understand the components of waveforms and expected values for the patient. Everyone needs to take advantage of the time savings these systems offer, but should educate ourselves enough to utilize them correctly, thus ensuring we don’t end up with false values,
Inventory Management and Recall Capabilities with RFID Technology
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The Michigan Congenital Heart Center (MCHC), located within C.S. Mott Children's Hospital at the University of Michigan, has earned the reputation as a national and international leader in providing comprehensive care for congenital heart patients. With a talented team of cardiac surgeons, cardiologists, intensive care specialists, nurses, anesthesiologists, radiologists, and other allied professionals, we provide care to children and adults suffering from congenital heart disease and perform nearly 1,000 cardiac catheterizations and over 200 interventions annually.
In 2005, MCHC evaluate
Educational Approaches: How does a diagnostic cardiac catheterization lab convert to an interventional lab?
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To facilitate the transition, the hospital applied in the spring of 2005 for involvement in the Cardiovascular Patient Outcomes Research Trial (C-PORT). C-PORT was organized to gauge the feasibility of performing percutaneous coronary interventions (PCI) for acute myocardial infarctions in smaller community hospitals. The facilities currently do not perform elective PCIs or have on-site cardiovascular surgical support. In most states, angioplasty may only be performed at hospitals with cardiac surgical programs in the event of complications that require more invasive treatment. Patients were a
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