What type of procedures are performed at your facility?

UHS Cath Labs perform about 15,686 procedures annually, approximately 300 procedures per week. We perform various cardiac and peripheral interventions, including adult diagnostic heart studies, electrophysiology (EP) studies, device implantations, percutaneous transluminal coronary angioplasty (PTCA), cardiac stenting, alcohol (ETOH) ablations, chronic total occlusions (CTOs), atrial septal defect (ASD), patent foramen ovale (PFO) and ventricular septal defect (VSD) closures, intravascular ultrasound (IVUS), rheolytic thrombect

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A 3.5 x 15 mm Driver (Medtronic, Inc., Minneapolis, MN) stent was directly deployed in the circumflex artery without difficulty (Figure 2). On the third day, the patient developed chest pain with new electrocardiographic infero-lateral T-wave inversions (Figure 3). Due to availability issues, another physician performed urgent cardiac catheterization and found the circumflex stent to be widely patent. However, the left main (LM) lumen was significantly narrowed, hugging the catheter. There was accompanying dampening of the pressure waveform. Given the recent intervention, the catheterizing phy

Because the true size of coronary arteries is unknown, it is common practice in many labs to give NTG before every angiogram. Enhanced vasomotor tone is often evident during angioplasty and can be clearly seen when IC NTG is used to produce maximal vasodilation. The NTG permits better assessment of stenosis severity, eliminates false narrowings (i.e., spasm) and produces the best measurement of absolute vessel size for device selection.

Catheter-induced vasospasm is produced by mechanical stimulation of a vessel by contact with a catheter. Poking and prodding of these muscular arteries m

Each issue of Cath Lab Digest includes a spotlight interview, generally authored by a cath lab manager. The interview begins with a question about the size of the cath lab and number of staff members. As a former cath lab manager, I understand the frustration of finding benchmarking information on staffing ratios and work labor units. Justifying the amount of staff required to safely and efficiently operate a department is an ongoing challenge impacted not only by volume of cases, but also technological advances and procedure type. Labor, as the most expensive component of operating exp

The hybrid cath lab is a new concept for delivering advanced patient care. In a hybrid application, the cath lab doubles as an operating room so that a patient undergoing a cardiac cath procedure can immediately have surgery if required. This cutting-edge setting allows physicians to address patient needs quickly, eliminating the need to schedule additional surgical procedures, and may become increasingly commonplace in contemporary healthcare facilities. However, combining the requirements of surgery rooms and cardiac cath rooms in an existing cath room does pose design and construction chall

Recently, there has been an increased focus in the field of interventional cardiology on proper techniques. What has sparked renewed interest on this topic?

When drug-eluting stents (DES) were first introduced, restenosis rates were so low that the importance of technique was lost. Recent issues with stent thrombosis rates, particularly late-stent thrombosis rates, have reminded us that proper deployment and case selection are still very important. In fact, recent data suggests that approximately two-thirds of late-stent thrombosis cases with DES may be due to stent underexpansion1,

Mistake #1: Not planning for the proper amount of time.

How many meetings have you attended where the presenter says, I've got a lot of slides. We're going to fly through this information. Stay with me, since we only have a short period of time? For the next 60 minutes, you see a myriad of slides, with the speaker flipping through them almost as if you're watching a moving picture. With all due respect to individuals who have spent hours, days, months and years in research, you can't take a sip of water from a fire hydrant. Presenters must format their presentations to fit the exact

Why did you choose to work in the invasive cardiology field?

I wanted to work in a critical care environment, and as an LPN, options were limited. The cath lab was as close as I could get to doing critical care. I started in the invasive vascular part of the lab, and when I returned from working one year in open heart surgery, I worked in the electrophysiology lab. I left the cath lab environment for a second time to be a pacemaker nurse for a cardiology group, and returned a year later to be the same cath lab's clinical educator.

Can you describe your role in the cath lab?

In the Patient’s Shoes