Issue

Cardiovascular Computed Tomography: Important to the Cath Lab

admin — Wed, 30 Jun 2010 09:36:59 -0400

The Society of Cardiovascular Computed Tomography (SCCT) has its annual meeting July 15-18 in Las Vegas. SCCT President-Elect Dr. Budoff discusses the state of cardiac CT and what’s happening at the annual meeting.

How is CT angiography going to interact with the cath lab?

IABP Before PCI May Help AMI and Shock Patients: Is it all in the timing?

admin — Wed, 30 Jun 2010 09:43:20 -0400

Background

Cardiogenic shock occurs in up to 10% of patients presenting with acute myocardial infarction (AMI) and is associated with mortality rates approaching 50% even with early revascularization and use of intra-aortic balloon counterpulsation (IABP).^1,2 IABP was first introduced more than forty years ago, but is currently still the most commonly used mechanical method for cardiac circulatory support. Current American College of Cardiology/American Heart Association (ACC/AHA) practice guidelines for ST-elevation myocardial infarction (STEMI) list IABP therapy in cardiogenic shock complicating AMI as a class I recommendation with level of evidence B.³ The European Society of Cardiology STEMI guidelines also strongly recommend supportive treatment with IABP as a class I recommendation with level of evidence C.⁴

Salem Hospital Cath Lab

admin — Wed, 30 Jun 2010 10:12:58 -0400

The Salem Hospital cath lab shines with its award-winning care, low employee turnover and new state-of- the-art facilities. Located in Salem, Oregon, the Salem Cardiovascular Center cath lab at Salem Hospital serves more than 360,000 people in a two-county region, and still more from the Pacific coast to the Cascade Mountains.

Tell us about your cath lab.

The cath lab completed a move last year to a new $220-million patient care tower. The cath labs are now 30 percent larger and have convenient overhead booms so medical teams can move about easily with the latest in technology at their disposal.

CREST: Further Data Analysis Confirms Wisdom of Appropriate Patient Stratification

admin — Wed, 30 Jun 2010 11:39:44 -0400

What can you tell us about the latest findings from the CREST trial (Carotid Revascularization Endarterectomy vs. Stenting Trial) and the further evaluation of the data?

Caring for Cath Lab Patients From 1980 to the Present Day: Angio Recovery

admin — Wed, 30 Jun 2010 12:09:13 -0400

I started in cath lab/specials at our 378-bed community hospital back in 1979. At that time patients were admitted the night before to the telemetry unit. The admitting process was tedious and consisted of multiple phone calls to the cardiologist regarding orders, lab results, and other patient issues. The post care was filled with the same issues and led to poor outcomes. In 1980, I was asked to open an area where the patients could come in that morning and go home from that evening. No hospital in our area had such a unit. There was little information to reference regarding outcomes for same-day discharge on cath lab patients. The community standard was not to send patients home the same day. All eyes were on us to see just how safe same-day discharge would prove to be.

The hospital gave us a wing on the fourth floor at the very end of the hall, with 8 beds.

Ask the Clinical Instructor

admin — Wed, 30 Jun 2010 12:23:06 -0400

I just transferred from interventional radiology to the cath lab. We used the intra-aortic balloon pump (IABP) last week, and I just don’t understand how a balloon inflation in the aorta can have any value.
– Cath lab staff member, rural Alabama, via Facebook

The use of the intra-aortic balloon pump (IABP) can certainly be counterintuitive. Understanding the differences in coronary artery physiology and the concepts of IABP usage can help. Granted, a full IABP lesson could take many hours, or several articles, to properly address. You should take advantage of your IABP clinical representative to get a full tutorial. I will only address the information specific to your question in this article.

CCC Live Cases Celebrates its One-Year Anniversary

admin — Wed, 30 Jun 2010 13:24:53 -0400

(Dr. Sharma) Our live case series has been a tremendous success.

June 8th will mark our 12th case. Over 12,000 people from 54 countries have visited our CCC Live website. I have received so many emails! People are happy that we have started this educational live symposium, and now, they can even download slides.

For our 12th case, we kept the last 5 minutes for a celebration and thanks to the cath lab staff and all involved — most importantly, thanks to our viewers. The president and COO of Mount Sinai Hospital, Wayne E. Keathley, will be joining us for this celebration of our first-year anniversary.

Managing to Increase Morale

admin — Wed, 30 Jun 2010 13:35:05 -0400

Management is not simple, by any means. The premise of successful management relies on the successful communication between employees and managers, combined with respect and positive energy. If both parties function within these basic elements, productivity and efficiency will be the result.

Consciously or unconsciously, successful managers employ several tools or concepts, also known as management styles, to motivate people to behave in ways that are in the organization’s best interest. Simply stated, these styles are different kinds of behaviors we use to produce the reactions we need to get the job done.

An “autocratic” leader is someone who believes that bosses give orders and employees carry them out without being active in the decision- making process.

A Q&A for Cath Labs with Physicians Performing Radial Access

admin — Wed, 30 Jun 2010 13:57:35 -0400

We would like to go transradial for all procedures; however, one of our interventionalists stated that you cannot do complex procedures and utilize 7 or 8 French sheaths for patients. In your experience, is this true?

As you can see from Figure 1, it is possible to insert a large sheath in the radial artery on a case-by-case basis. With females, I would tend to be more careful, and with men, it is more advantageous to insert a large sheath.

Complex cases can be done transradially. I will share a chronic total occlusion (CTO) of the right coronary artery (RCA) utilizing the Crosser CTO Recanalization system by Flowcardia (Sunnyvale, CA). This case was done by Dr. Zaheed Tai.

Case Report

What We Learned After Starting a 'Radial First' Program

admin — Thu, 01 Jul 2010 08:54:47 -0400

Eight months ago, our lab took up the challenge that Olivier Bertrand of Laval Hospital in Quebec City laid down regarding becoming a predominantly radial access program for best patient outcomes. We re-read the articles in Cath Lab Digest by Drs Popma,¹Rao,²and Coppola.³ My partner, Dr. Pranav Patel, and I told the cath lab that the radial approach will be harder for us all at the start, but this should be a better way for the patients and ultimately, the lab. What did we learn from beginning a radial program from the ground up?