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.

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.

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 lab area, your teammates have arrived and you all start gathering information on the person you are about to meet and potentially save from death.

Michael Savage is a first-year student in the Cardiovascular Technology Program at Grossmont College in El Cajon, California. On October 17, 2003, one day after his 54th birthday, he was at home alone studying for an exam. The exam was to cover the anatomy and physiology of the coronary arteries and the signs and symptoms of myocardial infarction.

At approximately 5:00 pm, Michael experienced a sudden onset of pain that was localized to his left shoulder. The pain was very sharp in nature and slowly increased in severity. Mike was thinking, I can’t be having a heart attack while I’m studying about heart attacks! He decided that he should lie down, but when he tried to walk to his bedroom he began to feel lightheaded. At that point, he called 911!

Cross-training

There is some controversy over the role(s) available in the cath lab for different credentials and just to what extent they can and should be cross-trained. What do you feel are the proper role(s) or responsibilities for RNs, RCISs, and RT(R)s in the cath lab? What about other credentials like physician assistants (PAs)?

CVT Program is valuable

I am currently in school for a CVT program and I think what has been taught through the school is more beneficial than being trained on the job. With the CVT program, you learn about diagnosing and more prevention than with on-the-job training. Over time, on-the-job training would eventually broaden your knowledge, but with the schooling you have through the program, you have your foot in the door and are ready to jump in.

M. W.

Individual potential important

Those of us who have been in the cath lab setting for the past 15 years or more have witnessed dramatic changes, the majority of which are for the better, but some of which we may not be too sure. However, there are certainly many positive developments which have resulted in an improved work environment, such as streamlined operations, identification and definition of specific accountabilities and responsibilities, and a redefining of the team concept. Positive changes have also occurred in imaging technology, as well as with device improvements, such as drug-eluting stents and plaque ablation technology. However, one change that may not easily come to mind, but is significant, is the professional climate among cath lab peers. The era of comradery, the feeling of security and helpfulness, that is so important for old-timers as well as newcomers, as they try to deal with the cath lab demands, has been lost.

This image was taken by Dr. Jason H Rogers, Assistant Clinical Professor, Cardiovascular Medicine; University of California Davis Medical Center, Sacramento, California.

I am honored to acknowledge all Cath Lab Digest Annual Symposium on Cardiovascular Care (ASOCC) attendees in Orlando, Florida, June 3-5. Thank you for attending ASOCC! The Cath Lab Digest Annual Symposium provides a chance to learn, network and ask questions of the experts our engaging, experienced faculty and your fellow professionals, who just may have the hands-on knowledge you’re looking for. ASOCC attendees also received a unique bumper sticker:

I am a Navy-trained Cardiopulmonary Technologist with 18 years experience in the invasive cardiovascular field. I recently earned my fellowship with the Society of Invasive Cardiovascular Professionals (SICP). In 2002, I designed and developed the Oregon Cardiology Diagnostic Center, a physician-owned freestanding cardiac cath lab located in Eugene, Oregon. I am currently the manager of this facility.

Morton J. Kern, Editor.
Philadelphia, PA: Mosby, An Affiliate of Elsevier Science, 2003.
650 pages, with 496 illustrations.
Softcover $49.95
ISBN:0323022472
www.elsevierhealth.com