TWilliam2019
Guru
Pro: Right heart cath, left heart cath and coronary angiography only
Indication: Known mod-to-sev aortic insuff and aortic stenosis w heavily calcified aortic valve apparatus, anterior wall hypokinesis on recent echo, recent sev CHf
proc in detail:
after informed consent was obtained, the pt was brought to the cath lab, prepped and draped in the usual sterile fashion. Lidocaine was used for local anesthesia and versed for sedation. Benadryl and solu medrol were used for an IVP dye allergy. Seldinger tech was used to cannulate the righrt femoral vein and place a 7 french venous sheath. Swan Ganz cath was advanced to the r atrium, it could not be advanced further even with use of Swan wire There was a significent angle turning through the tricuspid valve, which could not be passed. Subsequently, a 7 french multipurpose cath was obtained and was inserted into the r atrium. with use of a reg j wire, the mulitpurpose cath could be advanced to the r ventricular outflow tract. However a subsequent bend cannot be madw traversing the rv outflow tract. The pt had recurrent VT during this maneuver: thus the procudure was abanoned. Only RV pressures were obtained. Subsequently, Seldinger technique was used to cannulate the r femoral artery and place a 5 french arterial sheath. JL4 and 3DRC catheteres were used for selective coronary angiography. Given the severe calcification of the aortic valve apparatus, the valve was not crossed during the procedure. following the procedure, cath and sheaths were removed, and hemostasis was obtained using manual compression. the pt tolereated the proc well wo any limiting complications.
Help would be appreciate
cardiology
physicians office
Indication: Known mod-to-sev aortic insuff and aortic stenosis w heavily calcified aortic valve apparatus, anterior wall hypokinesis on recent echo, recent sev CHf
proc in detail:
after informed consent was obtained, the pt was brought to the cath lab, prepped and draped in the usual sterile fashion. Lidocaine was used for local anesthesia and versed for sedation. Benadryl and solu medrol were used for an IVP dye allergy. Seldinger tech was used to cannulate the righrt femoral vein and place a 7 french venous sheath. Swan Ganz cath was advanced to the r atrium, it could not be advanced further even with use of Swan wire There was a significent angle turning through the tricuspid valve, which could not be passed. Subsequently, a 7 french multipurpose cath was obtained and was inserted into the r atrium. with use of a reg j wire, the mulitpurpose cath could be advanced to the r ventricular outflow tract. However a subsequent bend cannot be madw traversing the rv outflow tract. The pt had recurrent VT during this maneuver: thus the procudure was abanoned. Only RV pressures were obtained. Subsequently, Seldinger technique was used to cannulate the r femoral artery and place a 5 french arterial sheath. JL4 and 3DRC catheteres were used for selective coronary angiography. Given the severe calcification of the aortic valve apparatus, the valve was not crossed during the procedure. following the procedure, cath and sheaths were removed, and hemostasis was obtained using manual compression. the pt tolereated the proc well wo any limiting complications.
Help would be appreciate
cardiology
physicians office