POCKET GUIDE TO DIAGNOSTIC CARDIAC CATHETERIZATION

The Pocket Guide to Diagnostic Cardiac Catheterization provides general cardiology fellows, nurses, and technicians entering the cardiac catheterization laboratory a practical guide addressing key aspects of left and right heart catheterization, selective coronary angiography, and the utilization of other invasive cardiology procedures for diagnostic purposes.
Written by a team of physicians from Emory University Hospital’s Cardiac Catheterization Laboratories, practical pearls of wisdom about the technical aspects of cardiac catheterization and other invasive cardiology procedures are presented with step-by-step instructions and easy-to-follow illustrations in this quick reference of essential material.
Also included is a chapter with video clips that highlight the role and technical versatility of the multipurpose catheter in cardiac catheterization—a technique developed, taught, and learned over many generations in the cardiac catheterization laboratories at Emory University.

AUTHORS:
Andro G. Kacharava, MD, PhD; Emory University School of Medicine; Atlanta VA Medical Center, Atlanta, Georgia
Stephen D. Clements, Jr., MD, Emory Healthcare, Atlanta, Georgia
A. Maziar Zafari, MD, PhD; Emory University School of Medicine; Atlanta VA Medical Center, Atlanta, Georgia

TABLE OF CONTENTS:
1. A Brief History of Cardiac Catheterization
History of a Procedure
2. The Cardiac Catheterization Laboratory
Catheterization Laboratory Equipment
Contrast Agents
Radiation Exposure and Safety
3. The Tools
Percutaneous Access Needles
Guidewires
Vascular Sheaths and Dilators
Catheters
Manifold
4. Precatheterization Care
The Rule of the Rules
5. Vascular Access
Percutaneous Vascular Access
Femoral Artery Approach
Brachial Artery Approach
Radial Artery Approach
Femoral Vein Approach
Jugular Vein Approach
Subclavian Vein Approach
Basilic Vein Approach
6. Coronary, Renal, and Mesenteric Angiography
Angiographic Views and Projections
Indications and Contraindications of the Procedures
Selective Cannulation of the Native Left Coronary Artery (LCA)
Amplatz Coronary Catheter for Femoral, Left Brachial, or Radial Approaches
Selective Cannulation of the Native Right Coronary Artery (RCA)
Selective Cannulation of the Renal and Mesenteric Arteries
7. The Multipurpose Catheter
Historical Background
Multipurpose Catheter Basics
Torque and Rotation
Left Ventriculography with the Multipurpose Catheter
Right Coronary Artery (RCA) Cannulation
Left Coronary Artery (LCA) Cannulation
Coronary Bypass Grafts
Challenging Conditions
8. Angiography of Coronary Bypass Grafts
Venous and Free Arterial Grafts
Pediculed Arterial Grafts
9. Left and Right Ventriculography, Aortography, and Pulmonary Angiography
Radiologic Anatomy of the Heart and Left Ventriculography
Entering the Left Ventricle
Radiologic Anatomy of the Heart and Right Ventriculography
Aortography
Pulmonary Artery Angiography
10. Right Heart Catheterization
Indications and Contraindications of the Procedure
Femoral Vein Approach
Right Internal Jugular Vein Approach
Cannulation of the Coronary Sinus
11. Right and Left Heart Hemodynamics
Cardiac Hemodynamics
Interpretation of Right and Left Heart Pressure Tracings
Cardiac Output Measurement
Pulmonary and Systemic Vascular Resistance
12. Shunt Detection and Calculation
Oximetry for Shunt Calculations
13. Endomyocardial Biopsy
Indications and Contraindications of the Procedure
Jugular Vein Approach
Femoral Vein Approach
Femoral Artery Approach
14. Pericardiocentesis
Indications and Contraindications of the Procedure
Subxiphoid Approach
Apical Approach
15. Intra-Aortic Balloon Pump (IABP) Placement
Indications and Contraindications of the Procedure
Femoral Artery Approach
Left Brachial Artery Approach
16. Temporary Transvenous Pacemaker Placement
Indications and Contraindications of the Procedure
Femoral Vein Approach
Right Internal Jugular Vein Approach
17. Post-Cardiac Catheterization Care
Documentation of the Procedure
Vascular Access Site Closure
Obtaining Hemostasis of the Radial Arteriotomy Site
18. Approach to Complex Cases in Cardiac Catheterization
Left Main (LM) Coronary Artery Stenosis
Coronary Anomalies
Coronary Spasm and Myocardial Bridge
Aortic Stenosis
Pulmonic Stenosis
Mitral Stenosis
Tricuspid Stenosis
Tricuspid Regurgitation
Aortic Regurgitation
Mitral Regurgitation
Hypertrophic Cardiomyopathy
Cardiac Tamponade
Restrictive Cardiomyopathy versus Constrictive Pericarditis
Pulmonary Hypertension
Simple Cardiac Shunts
19. Useful Formulae and Normal Values
Index