This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Improvements in digital storage & resolution has largely replaced cine Study can be stored on CD-R or DVD’s for review
8 Cardiac catheterization
• The oxygen concentration can be measured across the valves and walls (septa) of the heart
• Pressures within each chamber of the heart and across the valves can be measured.
• The technique can even be performed in small, newborn infants.
• The catheter also serves the purpose of monitoring blood pressures in these different locations inside the heart.
• The angiogram procedure takes several hours, depending on the complexity of the procedure.
9Basic info about procedure
IV sites in either arm, groin, or neck.Flexible catheter inserted to IV through the blood vessel.Then, cathether is threaded thorough the blood vessel to
the heart.Pressure measured at this point. Iodinated contrast injected through catheter once it
reaches the heart.Fluoroscopy guides the cardiologist with the catheter location.
*Modified Seldinger only punctures one side of vessel – this Percutaneous method can be used for arteries or veins - describes the method of catheter introduction that is not a direct stick
*
14 Seldinger TechniqueSeldinger Technique
15
1515
What is this?When is it used in Cardiac Cath?
• used to inject a large amount (25 to 50 mL) of contrast material into either the right or left ventricle the aortic root, or the pulmonary vessels.
• Because the coronary arteries are of small caliber and of low flow rate, administration of contrast medium into these structures generally does not require a high-pressure injector.
16 CARDIAC CATHETERS• May be inserted in an artery or vein • information is collected on the valves, chambers,
and arteries, as well as the structure and function of the heart
• A cardiac cath can show a cardiologist the precise location of a blockage or defect
• The advantages of catheterization are as follows: 1.The risk of extravasation is
reduced.2.Most body parts can be
reached for selective injection.3.The patient can be positioned
27A stent graft or endograft used to repair aneurysm in the aorta and iliac region.
28
Cardiac Ablation
CARDIAC
ABLATION
29RF ABLATION
30
• Most often, cardiac ablation is used to treat rapid heartbeats that begin in the upper chambers, or atria, of the heart. As a group, these are know as supraventricular tachycardias, or SVTs. Types of SVTs are:
INDICATIONS• Atrial Fibrillation• Atrial Flutter• AV Nodal Reentrant
Tachycardia• AV Reentrant
Tachycardia• Atrial Tachycardia
In cardiac ablation, a form of energy renders a small section of damaged tissue inactive. This puts an end to arrhythmias that originated at the problematic site
31Cardiac Ablation
• Minimally invasive treatment for arrhythmias• Live fluoroscopy and angiography techniques
are used along with special electro physiologic equipment and catheters
• Performed by a doctor specializing in the hearts electrical system
• Pulse• ECG• Chest pain• Nausea• Syncope
32
• Catheter positions for routine electrophysiologic study.
• Multipolar catheters • are positioned in the • high right atrium near• the sinus node, • in the area of the • atrioventricular apex, • and in the coronary • sinus.
33 Your Hearts Electrical System
• Sinoatrial node- – “Natural Pacemaker”– Upper Right Atrium– Produces electrical signal 60-100 times a min
• Atrioventricular node-– The bridge that connects Atriums to Ventricles– Special cells allow electrical signals to pass
34CINE
• HIGHEST IN RADIATION DOSE • TO THE PATIENT / TECHNOLOGIST
• 1 MR/FRAME X 60 FRAMES/SEC FOR 30 MINUTES = ?
• HEAT LOADS?????
35
1 MR/FRAME X 60 FRAMES/SEC FOR 30 MINUTES =
• 1 X 60 = 60 mR/sec• 60 mR/sec x 60 sec = 3600mR/min
• 3600mR/min x 30 min =• 108000 mr OR 10.8 R
CINE DOSE
36Imaging Considerations
• Magnetic resonance imaging (MRI)
– Recently gained in popularity for use in cardiac studies– Uses cine loop– May be ECG gated
• Magnetic resonance angiography (MRA)
37 Nuc Med / Pet scanningPerfusion Scanning
•Myocardial perfusion scan•Most widely used procedure
•Gated cardiac blood pool scans
•Used to evaluate ventricles
•Positron emission tomography (PET)
Nuclear cardiologyUsed to diagnose CAD, congenital heart disease, and cardiomyopathy