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Cardiac Catheterization
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Coronary Angiography
Coronary Anatomy
Normal coronary anatomy
•
Anomalous origins of coronary arteries
(
Left coronary artery
•
Right coronary artery
) •
Congenital abnormalities of coronary arteries
•
Coronary artery segments
•
Cinefilm frame speed
•
Coronary artery dominance
(
Left dominance
•
Right dominance
•
Co-dominance
)
TIMI Flow Grade
TIMI flow grade 0
•
TIMI flow grade 1
•
TIMI flow grade 2
•
TIMI flow grade 3
TIMI Frame Count
TFC for SVG
•
TIMI Myocardial Frame Count
•
Washout TIMI Frame Count
TIMI Myocardial Perfusion Grade
TIMI MPG 0
•
TIMI MPG 1
•
TIMI MPG 2
•
TIMI MPG 3
Thrombus Grading
Thrombus Grade 0
•
Thrombus Grade 1
•
Thrombus Grade 2
•
Thrombus Grade 3
•
Thrombus Grade 4
•
Thrombus Grade 5
•
Thrombus Grade 6
Lesion Complexity
Type A
•
Type B
1
•
Type B
2
•
Type C
Dissection Classification
Type A
•
Type B
•
Type C
•
Type D
•
Type E
•
Type F
Coronary Collaterals
Grade 0
•
Grade 1
•
Grade 2
•
Grade 3
•
Rentrop and Cohen’s Collateral Classification
Lesion Morphology
Myocardial bridge
•
Definitions of Preprocedural Lesion Morphology
•
Luminal irregularities
•
Disease extent
•
Arterial foreshortening
•
Infarct related artery
(
Culprit lesion
) •
Reocclusion
•
Restenosis
•
Degenerated saphenous vein graft
•
Coronary artery fistula
Angiographic complications
Distal embolization
•
Coronary spasm
•
Abrupt closure
•
Side branch loss
•
Slow flow
•
No-reflow
•
Pulsatile flow
•
Flow deceleration
•
Ectasia
•
Intimal flap
•
Staining
•
Performing Coronary Angiography
Patient preparation
•
Catheter selection
•
Standard angiographic views
•
High risk groups
•
Patients with special need
•
Access site closure
(
Manual compression
•
Assisted compression
•
Closure devices
) •
Quantitative Coronary Angiography
(
QCA
)
Minimal lumen diameter
•
Percent stenosis
•
Reference diameter
•
Lesion length
•
Residual stenosis
•
Average reference segment diameter
•
Plaque area
•
Plaque volume
•
Contrast Media
High-osmolar contrast media
•
Iso-osmolar contrast media
•
Low-osmolar contrast media
Left Ventriculography
&
Aortography
Ejection fraction
•
Aortography
•
Quantitative Left Ventricular Analysis
(
LAO projection
•
RAO projection
•
LVA
) •
Left Ventricular Wall Motion Analysis
(
Normokinesia
•
Hypokinesia
•
Akinesia
•
Dyskinesia
•
Aneurysm
) •
Evaluation of mitral regurgitation
•
Evaluation of aortic regurgitation
Right Heart Catheterization
Pressure waveforms
(
Right atrial pressure
•
Rirght ventricular pressure
•
Pulmonary artery pressure
•
Pulmonary artery wedge-pressure
) •
Endomyocardial biopsy
Complications
Access site complications
•
Dumping
•
Contrast hypersensitivity
•
Contrast induced nephropathy
•
Hypotension
•
Hypertension
•
Dissection
•
Vessel perforation
•
Acute myocardial infarction
•
Ventricular fibrillation
•
Cardiac arrest
•
Stroke
•
ASD
•
VSD
•
Pulmonary emboli
•
Myocardial rupture
•
Peripheral arterial emboli
•
Radiation injury
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