Artery Access For Coronary Intervention

A coronary angiography provides information about the hearts blood pressure and functioning. This procedure can identify whether the coronary arteries are blocked or narrowing. A tube/camera is passed through an artery in the groin or arm; it is guided using x-rays up to the heart. A coronary angiogram is a safe procedure, but there are some small side affect. You may feel a slightly strange sensation when the dye is put down the catheter, a small amount of bleeding when the catheter is removed, a bruise in your groin or arm.

Facilities, performing coronary CTA, should develop and adhere to evidence based coronary CTA protocols for optimal, high quality, cost-effective, patient-centered care. A comprehensive review of the literature was performed using CINAHL, PubMed, MEDLINE, and Medscape search engines, and with the terms ?coronary CTA?, ?protocols?, ?guidelines?, ?radiation?, ?contrast?, ?beta-blockers?, and ?radiology nursing?.

This past Friday in the cardiac catheterization lab I began my day with continuing the work that I was previously assigned to do last week where I collected the data of patient's Cardiothoracic surgery. I continued to familiarize myself with the different types of Cardiothoracic surgery procedures, however, the specific reports I was working with, they are called TAVR report (Transcatheter Aortic Valve Replacement). I later learned and was explained to, the TAVR multiple procedures and its causes, which is aortic stenosis. As for the procedures, a valve needs to be placed in the heart and each procedure delivers it a different way. The three ways the valve can be placed in the heart is through the heart's femoral artery (the transfemoral approach),

Fibrinolytic therapy uses drugs to break up blood clots. This therapy is used with heart attack patients to remove the blockage that caused the myocardial infarction. Another treatment option is percutaneous coronary intervention (PCI). PCI involves the placement of a catheter into the blocked artery to allow blood to flow. The purpose of this paper is to examine the outcomes of these two procedures and to suggest that percutaneous coronary intervention is superior to fibrinolytic therapy.

"In 2006, more than 690,000 open heart surgeries were performed in the United States. These included surgeries to correct and repair defective valves as well as coronary artery bypass surgery. As recently as 70 years ago, these surgeries would have been impossible. The heart lung machine had yet to be invented, allowing surgeons to temporarily stop and start the heart. Prior to its invention, the longest a heart could be stopped was 30 to 40 minutes---not enough time to complete extensive surgery" (Smith, 2009). Since then, a number of minimally invasive surgical procedures have been introduced that permit surgeons to perform a variety of surgeries, making smaller incisions that leave smaller scars, reduce the chance of infection, are less painful to the patient and necessitate shorter hospital stays. These include minimally invasive direct coronary artery bypass, off-pump coronary artery bypass, videoscopic surgery and robotic-assisted heart surgery.

Funny, but often when surgery &/or a lesser procedure is offered to a surgeon i.e. Dr. John Peters' situation, surgeons tend to go for the noninvasive route, even though they make their money by cutting into other people to get things done and usually done better and so be like Dr. Peters and who has had 2 angioplasties and no bypass(es), at least not yet. There was a cardiac surgeon on the west coast who actually went one step further than Peters, in that not only did he have angioplasties and not coronary bypass surgery done twice and both times the cardiologists and the cardiac surgeons had strongly recommended the bypass for a better fix for him, but he also continued to

A non-ST elevation acute coronary syndrome (NSTE-ACS) is a very common presentation to emergency departments everywhere, as well as primary care practices. Therefore, it is important that all providers be well informed on the effectivity of certain treatment regimens.

Providing care for post percutaneous coronary intervention (PCI) patients has evolved and the guidelines and protocols have been heavily influenced by research and evidence based practice (EBP). Unfortunately, coronary heart disease has become a major issue for the health status of Americans across the lifespan. According to the CDC, “About 610,000 people die of heart disease in the United States (U.S.) every year – that’s 1 in every 4 deaths.” In addition, treating coronary heart disease patients has negatively impacted the economic status of U.S. healthcare. Therefore, to manage

Catheter angiography can accurately evaluate aortic pararenal patency. This is especially important when placing engrafts at the iliac bifurcation site. CTA is more sensitive to assessing endoleaks occurring after EVAR procedures, but digit subtraction angiography (DSA) is more accurate in classifying endoleaks. This is possible because the direction of flow in or out of the aneurysm site can be evaluated via DSA. Catheter angiography plays a role in imaging intraoperative EVAR patients for endoleak classification and for post-operative re-intervention (Francois et al., 2012). Figure 5 illustrates an arteriogram taken in preparation for an EVAR procedure, while Figure 6 was taken after the EVAR procedure was

“the conclusion that peripheral IV catheters can be changed only when clinically indicated without increased risk to the patient and with cost savings for healthcare organizations.”

Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the mid-1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure, bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.

a 95.7 percent success rate. Thirty-day mortality is limited to 0.4 percent, and stroke rate

To diagnose a coronary artery disease (CAD) the doctor will use a coronary angiogram procedure to find the percentage of blockage or narrow in arteries, the angiogram results will help the doctor to decide a decision on patient treatment depends on the percentage of blockage on coronary artery, age, weight, and whether patients have other medical conditions, like diabetes . In cases with obstructive average a 50% or slightly more are treated by medications and Balloon angioplasty, but what about the cases with more than one artery completely blockage or the medication and stent do not help them? The doctor will choose a coronary artery bypass grafting surgery (CABG) to restore blood flow in the heart, CABG is a surgery done through replacement

The advantages and disadvantages of staged complete revascularization (SCR) comparing to complete revascularization treated immediately (ICR) during primary PCI remain controversial also. While that may be the case, the optimal strategies to perform PCI in MVD patients still remain elusive and an area of robust research. In the past, the 2011 American College of Cardiology Foundation/American Heart Association/Society for Cardiac Angiography and Interventions (ACCF/AHA/SCAI) 7 and 2012 ESC guidelines 8 both advocated that index PCI should be limited to the infarcted vessel only unless there is hemodynamic compromise or refractory ischemia after the procedure, and complete revascularization (CR) is considered

Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal.