Books for B. Sc Operation Theatre and Anesthesia Technology. Labels B. And you can able to find a lin Hall PhD and Michael E. In this post, you can able to download Davidson's Principle and Practice of Medicine 23rd Edition as pdf and also you can buy that f Recover your password. Get help. Related posts:. Recent Posts. Landzberg and James E.
Pressure Measurement William Grossman 8. Shunt Detection and Quantification William Grossman Carabello and William Grossman Goldhaber Jaff, Briain D. Fifer and William Grossman Kern and Michael J.
Fitzgerald, and Paul G. Yock Endomyocardial Biopsy Kenneth L. Baughman and Donald S. Popma and Judith L. Meadows Coronary Stenting Gregg W. Stone Goldhaber, Nils Kucher, and Michael J.
Landzberg Fang and Andrew C. Eisenhauer Peripheral Intervention Briain D. MacNeill and Kenneth Rosenfield Profiles in Pericardial Disease John F.
Robb and Roger J. Laham Sommer Landzberg and Robert J. Silva, and Christopher J. His legacy, however, remains clear in the title of the book, in the content of the hemodynamic chapters, and hopefully in a lucid style that always seeks to balance theory and evidence-based medicine with practical technical tips. The basic structure of recent editions has been retained, with sections devoted to general principles, basic techniques, hemodynamic principles, angiographic techniques, evaluation of cardiac function, special catheter techniques, interventional techniques, and profiles of specific disorders.
The returning reader will find many major enhancements throughout this edition. Some examples are the updated treatment of digital x-ray systems and radiation biology, the enhanced treatment of complications and adjunctive pharmacology, the fuller discussion of percutaneous radial artery approach to left heart catheterization, and the strengthened treatment of both pediatric and adult congenital heart disease. Several chapters have been recast, including those relating to pulmonary angiography and pulmonary embolism, endomyocardial biopsy, circulatory assist devices, as well as profile chapters on coronary artery disease, cardiomyopathy and heart failure.
In addition, the interventional section has been totally revamped as pertains to atherectomy, thrombectomy, and distal embolic protection devices; bare metal and drug-eluting stents; percutaneous valve therapies including new approaches to catheter-based reduction of mitral regurgitation and percutaneous valve replacement for aortic stenosis ; and the interventional treatment of pediatric and adult congenital heart disease.
The coverage of peripheral vascular disease has continued in three chapters devoted to the head-to-foot review of diagnostic methods, interventional techniques, and case examples. These represent only a few of the most prominent changes introduced in an attempt to capture the major progress made in this field since the publication of the sixth edition in We have also revised and expanded the companion DVD-ROM compared with that of the previous edition—it now includes more than digital cases that show a full spectrum of normal anatomy, anatomic variations, diagnostic and interventional procedures, and a variety of complications.
This companion DVD-ROM also includes more than 20 animations that illustrate the principle of action of various invasive and interventional devices.
These materials are an important supplement and significant extension of the printed text, and are intentionally encoded in unprotected standard media formats to enable their extraction for use in teaching materials or presentations. The growing clinical use and rapid evolution of interventional techniques, and the ongoing introduction of important new methods all underscore the importance of providing a comprehensive, balanced, and up-to-date resource in this field.
It is my sincere hope that this text will be one such resource, and prove valuable to both new entrants to invasive and interventional cardiology Fellows and new catheterization laboratory staff and to the more than 10, practitioners of this specialty worldwide.
Because the pace of development in this area is continuing to accelerate, readers are encouraged to monitor new publications and trial results frequently or keep abreast of new developments in this area through such resources as Up-todate www.
Even while working to provide the latest current information, I have tried not to lose the incremental layer on layer historical flavor and theoretical background including approaches that were tried and abandoned that have been such an integral part of this textbook. Most important, I hope that my efforts and those of the contributing authors to describe the scope and depth of invasive and interventional cardiology will translate into the better patient care, as invariably stems from an improved understanding on the part of those who perform and interpret cardiac catheterization procedures.
Beyond the list of contributing authors, I wish to thank my many colleagues across the country and throughout the world whose shared experiences have been woven into much of the material contained in the book, as well as several generations of our Cardiology Fellows for their questions and research efforts that have led to many of the principles and techniques described throughout this book. Donald S. Baim, M.
At that time, most cases were captured onto 35 mm cine film and then transferred to electronic media. During the past 5 years, virtually all cardiac catheterization laboratories have converted from 35 mm film to DICOM-standard digital recording as discussed in Chapter 2 , which allows far easier and higher-quality image migration into secondary i. We have also revised the presentation format to the now prevalent electronic slide show containing imbedded movies.
Most cases conclude with a summary of important teaching points, and references to the particular chapters in the printed textbook. Either way, we can assure you of 2 things: 1 there are procedures, findings, and complications that even the most experienced operators have never encountered, and 2 failure to delve into these case examples will limit the overall educational benefit provided by the 7th edition!
Please feel free to transfer any of the case examples from the DVD to your own computer for use in educational formats such as cath lab teaching conferences or presentations at meetings, as long as you acknowledge their source. Baim Jeffrey J. Louis University Hospital St. By turning this key, Cournand and his colleagues led us into a new era in the understanding of normal and disordered cardiac function in humans.
According to Cournand 2 , cardiac catheterization was first performed and so named by Claude Bernard in The subject was a horse, and both the right and left ventricles were entered by a retrograde approach from the jugular vein and carotid artery. In an excellent review of the history of cardiac catheterization, angiography, and interventional cardiology, Mueller and Sanborn 3 describe and cite references for experiments by Stephen Hales and others whose work antedates that of Claude Bernard.
Although Claude Bernard may not have been the first to perform cardiac catheterization, his careful application of scientific method to the study of cardiac physiology using the cardiac catheter demonstrated the enormous value of this technical innovation. An era of investigation of cardiovascular physiology in animals then followed, resulting in the development of many important techniques and principles pressure manometry, the Fick cardiac output a William Grossman authored this chapter in previous editions and contributed much of the historical information.
Werner Forssmann usually is credited with performing the first cardiac catheterization of a living person—himself 4. At age 25, while receiving clinical instruction in surgery in Germany, he passed a catheter 65 cm through one of his left antecubital veins, guiding it by fluoroscopy until it entered his right atrium.
He then walked to the radiology department which was on a different level, requiring that he climb stairs , where the catheter position was documented by a chest roentgenogram Fig. During the next 2 years, Forssmann continued to perform catheterization studies, including six additional attempts to catheterize himself. Bitter criticism, based on an unsubstantiated belief in the danger of his experiments, caused Forssmann to turn his attention to other concerns, and he eventually pursued another catheter-related career as a urologist 5.
Nevertheless, for his contribution and foresight he shared the Nobel Prize in Medicine with Andre Cournand and Dickinson Richards in He wrote: If cardiac action ceases suddenly, as is seen in acute shock or in heart disease, or during anesthesia or poisoning, one is forced to deliver drugs locally.
In such cases the intracardiac injection of drugs may be life saving. However, this may be a dangerous procedure because of many incidents of laceration of coronary arteries and their branches leading to cardiac tamponade, and death. At age 25, while receiving clinical instruction in surgery at Eberswalde, Werner Forssmann passed a catheter 65 cm through one of his left antecubital veins until its tip entered the right atrium.
He then walked to the radiology department where this roentgenogram was taken. Klin Wochenschr ; In , Padillo and coworkers reported right heart catheterization and measurement of cardiac output in two subjects 2. Except for these few early studies, application of cardiac catheterization to study the circulation in normal and disease states was fragmentary until the work of Andre Cournand and Dickinson Richards, who separately and in collaboration produced a remarkable series of investigations of right heart physiology in humans 7—9.
Further developments came rapidly in the s and s. Retrograde left heart catheterization was first reported by Zimmerman and others 24 and Limon-Lason and Bouchard 25 in The percutaneous rather than cutdown technique was developed by Seldinger in and was soon applied to cardiac catheterization of both the left and right heart chambers Trans-septal catheterization was first developed by Ross 27 and Cope 28 in and quickly became accepted as a standard technique.
Selective coronary arteriography was reported by Sones and others in and was perfected to a remarkable excellence over the ensuing years 29, Coronary angiography was modified for a percutaneous approach by Ricketts and Abrams 31 in Chapter 1: Cardiac Catheterization—History and Current Practice Standards and Judkins 32 in In Swan and Ganz introduced a practical balloon-tipped, flow-guided catheter technique enabling the application of catheterization outside the laboratory Better radiographic imaging techniques and less toxic radiographic contrast agents have been developed progressively, as the number of diagnostic catheterizations has exceeded 2,, per year.
Encouraged by the success of PTCA but challenged by its shortcomings, physician and engineer inventors have developed and introduced into clinical practice a panoply of new percutaneous interventional devices over the past decade.
This includes various forms of catheter-based atherectomy, bare metallic stents, and drugeluting stents, which together have largely solved earlier problems relating to elastic recoil, dissection, and restenosis of the treated segment see Chapters 23 and These newer techniques are usually subsumed along with conventional balloon angioplasty under the broader designation of percutaneous coronary intervention PCI.
Similar techniques have also developed in parallel for the treatment of peripheral arterial atherosclerotic disease, which is a common cause of morbidity and even mortality in patients with coexisting coronary disease see Chapters 14 and The development of percutaneous coronary intervention has also stimulated the development of other techniques for the treatment of structural heart disease.
Catheter devices developed to close intracardiac shunts in pediatric patients have now been adapted to close adult congenital and acquired defects see Chapter Balloon valvuloplasty was developed in the mids and remains successful for the treatment of rheumatic mitral stenosis, but because of early recurrence is now used as a treatment for aortic stenosis only in patients who are not candidates for aortic valve replacement surgery.
Newer technologies for percutaneous aortic valve replacement and percutaneous reduction of mitral regurgitation are now entering clinical testing see Chapter In essence, these new procedures have made interventional cardiology a new field in cardiovascular medicine, whose history is well summarized by Spencer King 36 , and the interested reader is referred there for further historical details.
But it is thus clear in the 21st century that interventional cardiology—by virtue of its new technologies, potent adjunctive drug therapies, expanding indications, 5 and improving results—has blossomed. In many ways, these therapeutic modalities rather than purely diagnostic techniques have now become the centerpiece within the broad field of cardiac catheterization.
Although the emphasis thus lies appropriately on this dynamic field of catheter-based intervention, we can ill afford to lose sight of the basic principles of catheter insertion, hemodynamic measurement, high-quality angiography, and integration of catheterization findings with the overall clinical scenario as the foundations on which all current interventional techniques are built and from which future evolution of cardiac catheterization will proceed.
As with any invasive procedure, the decision to perform cardiac catheterization must be based on a careful balance of the risk of the procedure against the anticipated benefit to the patient. As an example, a summary of the indications for cardiac catheterization in patients with stable angina is given in Table 1.
The basic principle is that cardiac catheterization is recommended to confirm the presence of a clinically suspected condition, define its anatomic and physiologic severity, and determine the presence or absence of associated conditions when a therapeutic intervention is planned in a symptomatic patient.
The most common indication for cardiac catheterization today thus consists of a patient with an acute coronary ischemic syndrome unstable angina or acute myocardial infarction in whom an invasive therapeutic intervention is contemplated.
The goal of cardiac catheterization in such patients is to identify the culprit lesions and then to restore vessel patency via PCI. In a few such patients, the diagnostic portion of the catheterization procedure may reveal other features e. Although few would disagree that consideration of heart surgery is an adequate reason for the performance of catheterization, clinicians differ about whether all patients being considered for heart surgery should undergo preoperative cardiac catheterization.
Many young patients with echo-proven valvular disease and no symptoms of myocardial ischemia are sometimes operated on using only noninvasive data, but the risks of catheterization in such 6 Section I: General Principles TABLE 1. Level of Evidence: B 2.
Patients with high-risk criteria on noninvasive testing [Table 23 in source] regardless of anginal severity. Level of Evidence: B 3. Patients with angina who have survived sudden cardiac death or serious ventricular arrhythmia. Level of Evidence: B 4. Patients with angina and symptoms and signs of CHF.
Level of Evidence: C 5. Patients with clinical characteristics that indicate a high likelihood of severe CAD. Level of Evidence: C 2. Patients with inadequate prognostic information after noninvasive testing. Level of Evidence: C 3. Patients with CCS class I or II angina who respond to medical therapy and who have no evidence of ischemia on noninvasive testing. Patients who prefer to avoid revascularization. Level of Evidence: C Class I: Conditions for which there is evidence or general agreement that a given procedure or treatment is useful and effective.
J Am Coll Cardiol. By providing the surgical team with a precise and complete road map of the course ahead, cardiac catheterization can permit a carefully reasoned and maximally efficient operative procedure.
Furthermore, information obtained by cardiac catheterization may be invaluable in the assessment of crucial determinants of prognosis, such as left ventricular function, status of the pulmonary vasculature, and the patency of the coronary arteries. For these reasons, we recommend cardiac catheterization or at least coronary angiography in nearly all patients for whom heart surgery is contemplated, even if the severity of valve disease and ventricular function have been determined by preoperative echocardiography.
Catheterization data can also inform other nonsurgical therapeutic considerations. Although a clinical diagnosis of primary pulmonary hypertension can often be made by echocardiography, cardiac catheterization is usually required a to confirm the diagnosis and b to assess potential responsiveness to pharmacologic agents, such as epoprostenol Catheterization can also be used to optimize pharmacologic therapy for advanced congestive heart failure.
Chapter 1: Cardiac Catheterization—History and Current Practice Standards Another broad indication for performing cardiac catheterization is to aid in the diagnosis of obscure or confusing problems, even when a major therapeutic decision is not imminent. A common instance of this indication is presented by the patient with chest pain of uncertain cause, about whom there is confusion regarding the presence of obstructive coronary artery disease. Both management and prognosis of this difficult problem are greatly simplified when it is known, for example, that the coronary arteries are widely patent.
Another example within this category is the symptomatic patient with a suspected diagnosis of cardiomyopathy. Although some may feel satisfied with a clinical diagnosis of this condition, the implications of such a diagnosis in terms of prognosis and therapy such as long-term bed rest or chronic anticoagulant therapy are so important that we feel it worthwhile to be aggressive in ruling out potentially correctable conditions e.
Research On occasion, cardiac catheterization is performed primarily as a research procedure. Although research is conducted to some degree in many of the diagnostic and therapeutic studies performed at major medical centers, it usually relates to the evaluation of new therapeutic devices e. All such studies 41 require prior approval of the Food and Drug Administration FDA in the form of an Investigational Device Exemption, of the local Committee on Human Research at the institution Institutional Review Board, or IRB , and attainment of informed consent after the details of the risks and potential benefits of the procedure and its alternatives have been thoroughly explained.
Even so, this is quite different from a catheterization that is performed solely for the purpose of a research investigation as a 6-month follow-up angiogram after a new stent might be. Contraindications Although it is important to carefully consider the indications for cardiac catheterization in each patient, it is equally important to discover any contraindications. Over the years, our concepts of contraindications have been 7 modified by the fact that patients with acute myocardial infarction, cardiogenic shock, intractable ventricular tachycardia, and other extreme conditions now tolerate cardiac catheterization and coronary angiography surprisingly well.
At present, the only absolute contraindication to cardiac catheterization is the refusal of a mentally competent patient to consent to the procedure. But a long list of relative contraindications must be kept in mind, including all intercurrent conditions that can be corrected and whose correction would improve the safety of the procedure.
Table 1. For example, ventricular irritability can increase the risk and difficulty of left heart catheterization and can greatly interfere with interpretation of ventriculography; therefore, it should be suppressed if possible prior to or during catheterization.
Other conditions that should be controlled before elective catheterization include intercurrent febrile illness, decompensated left heart failure, correctable anemia, digitalis toxicity, and hypokalemia. Allergy to radiographic contrast agent is a relative contraindication to cardiac angiography, but proper premedication and use of a newer nonionic low osmolar contrast agent can substantially reduce the risks of a major adverse reaction, as discussed in Chapter 2.
Even so, severe allergic reactions or even anaphylaxis can occur, and the operator and catheterization laboratory staff should be well versed in managing the procedure. Anticoagulant therapy is more controversial as a contraindication. Uncorrected hypokalemia or digitalis toxicity 3. Intercurrent febrile illness 5. Decompensated heart failure: especially acute pulmonary edema, unless catheterization can be done with the patient sitting up 6.
Severe allergy to radiographic contrast agent 8. These agents may be continued through and after the catheterization, particularly with the use of groin puncture closure technology, with only a small increase in the risk of local bleeding. If a complication arises, these agents can often be reversed protamine, platelet transfusion or allowed to wear off. But the view regarding oral anticoagulants e. This is best done by withholding warfarin for 3 to 5 days before the procedure, potentially switching to subcutaneous low—molecularweight heparin or intravenous heparin for a strong anticoagulant indication e.
If more rapid reversal of oral anticoagulation is required, we favor administration of fresh-frozen plasma rather than vitamin K, which can occasionally trigger a hypercoagulable state with thrombosis of prosthetic valves or thrombus formation within cardiac chambers, arteries, or veins.
Factors Influencing Choice of Approach Of the various approaches to cardiac catheterization, certain ones have only historical interest transbronchial approach, posterior transthoracic left atrial puncture, suprasternal puncture of the left atrium.
In this book, we will discuss in detail catheterization by percutaneous approach from various sites including femoral or radial arteries, femoral internal or jugular veins, trans-septal catheterization of the left heart, and apical puncture of the left ventricular puncture; Chapter 4. Although it has largely been supplanted by the percutaneous approach, we will also discuss catheterization by direct surgical exposure of the brachial artery and vein the so-called Sones technique, Chapter 5.
Ideally, the physician performing cardiac catheterization should be well versed in several of these methods at least one upper extremity approach as well as the femoral approach. This protocol may be so common e. If anything beyond this approach is planned, it is helpful to map this out, even preparing and posting a written protocol in the catheterization suite so that all personnel in the laboratory understand exactly what is planned and anticipate the needs of the operator.
Certain general principles should be considered in the design of a protocol if it includes hemodynamic measurements. First, hemodynamic measurements should generally precede angiographic studies, so that crucial pressure and flow measurements may be made as close as possible to the basal state. If a problem should develop during the later stages of a catheterization procedure atrial fibrillation or other arrhythmia, pyrogen reaction, hypotension, or reaction to contrast material , it will be beneficial to have the pressures and saturations already measured in advance, rather than waiting until the time of catheter pullback.
Third, measurements of pressure and cardiac output using true Fick, Fick with estimated oxygen consumption, or thermodilution, Chapter 8 should be made as simultaneously as possible. Beyond these general guidelines, the protocol will reflect differences from patient to patient and factor in changes when unexpected findings are encountered e. In a patient with an elevated creatinine in whom coronary intervention is anticipated, the left ventricular angiogram should be replaced by a noninvasive evaluation of ventricular function and even the number of baseline coronary injections should be limited.
Preparation and Premedication of the Patient It goes without saying that both the medical and the emotional preparation of the patient for cardiac catheterization are the responsibility of the operator.
This includes a full explanation of the proposed procedure in such terms that the patient can give truly informed consent. A study of psychologic preparation for cardiac catheterization 44 found that patients who received careful psychologic preparation had lower levels of autonomic arousal both during and after cardiac catheterization than did control subjects. It is our practice to have the patient fasting except for oral medications after midnight, but some laboratories allow a light tea and toast breakfast without ill effects.
We do not administer antibiotics prophylactically before cardiac catheterization, and we know of no controlled studies to support their use, but we may give a dose of intravenous cephalosporin plus two follow-up doses 8 and 16 hours later if there have been any breaks in sterile technique or if a groin closure device is being used particularly in a patient with diabetes mellitus. Various sedatives have been used for premedication.
Per conscious sedation guidelines, we usually administer small repeated doses of midazolam Versed 0. With appropriate prior counseling, good local anesthesia, and a reassuring presence by the operator and team throughout, a cardiac catheterization should be an easily tolerated procedure.
Reports of the Inter-Society Commission for Heart Disease Resources on optimal resources for cardiac catheterization facilities have appeared in , , , and The American College of Cardiology ACC and the Society of Cardiac Angiography and 9 Interventions published a clinical consensus document of cardiac catheterization laboratory standards in These reports deal with issues regarding lab construction, staffing, quality assurance, and more controversial topics such as the following: 1.
Traditional versus nontraditional settings for a cardiac catheterization laboratory; location within a hospital versus freestanding 2. Ambulatory cardiac catheterization: indications and contraindications 3. Ethical issues related to self-ownership of laboratories, self-referral of patients, and advertising 4. Optimal annual caseload for physicians and for the laboratory 5. Safety issues during conduct of the procedure sterile technique, heparin 6.
Physical arrangements and space requirement 7. Radiation safety and radiologic techniques Certain points, however, are worth discussing here. Location Within a Hospital Versus Freestanding The issue of whether cardiac catheterization laboratories should be hospital based, freestanding, or mobile has been the subject of much debate 45— Performance of catheterization in a freestanding or mobile unit should be limited to diagnostic procedures in low-risk patients.
Immediately available cardiac surgical backup is particularly critical for laboratories that perform diagnostic catheterization on unstable or high-risk patients, as well as for those that perform coronary angioplasty, endomyocardial biopsy, or trans-septal catheterization. Some states, however, have recently allowed performance of acute MI and even elective coronary intervention in hospitals without on-site cardiac surgery as long as it is performed by operators active at other sites and with a formal plan e.
Outpatient Cardiac Catheterization Outpatient cardiac catheterization has been demonstrated by a variety of groups to be safe, practical, and highly cost efficient, and is now widely practiced throughout the world. Outpatient catheterization can be accomplished by the radial, brachial, or femoral approaches, which allow the patient to be ambulatory within minutes of the 10 Section I: General Principles completion of the catheterization study 48— For femoral procedures, hemostasis can be obtained by manual compression for 10 minutes over the femoral artery, followed by a pressure dressing and bed rest for 2 to 4 hours, or use of a femoral closure device see Chapter 5 with 1 to 2 hours of bed rest before discharge.
The current Accreditation Council for Graduate Medical Education ACGME training guidelines call for a minimum of 4 months of diagnostic catheterization experience cases , with an additional 4 months of catheterization experience additional cases for individuals wishing to perform diagnostic catheterization in practice, within the basic 3-year Cardiovascular Disease fellowship Although many cardiologists in the past were jacks-of-all-trades performing office evaluation, noninvasive imaging, pacemaker implantation, and diagnostic cardiac catheterization, the current trends toward ad hoc coronary intervention as an adjunct to diagnostic catheterization see Chapter 22 make it less likely that new practitioners will be seeking to establish practices that are limited to diagnostic cardiac catheterization.
As the field continues to evolve, it is thus increasingly likely that an invasive cardiologist one who performs cardiac catheterization will also be an interventional cardiologist one who performs percutaneous coronary intervention. Subsequently, most interventional cardiologists completed a 1-year fellowship at a center that performed interventional procedures In , however, the ACGME established the structural, content, and faculty requirements for creating an accredited fellowship in interventional cardiology, requiring an additional 12 months beyond the 3-year general cardiovascular training period, during which at least interventional procedures should be performed 52, As of , there were accredited interventional programs with positions compared with accredited general cardiovascular disease programs with 2, positions.
In parallel, the American Board of Internal Medicine ABIM recognized the body of knowledge subsumed by interventional cardiology by offering a voluntary one-day proctored examination to individuals who met certain eligibility requirements—documented prior performance of coronary interventions the practice pathway, no TABLE 1. Knowledge of catheter techniques and risks Use of antithrombotic agents in interventional procedures Management of procedural complications Basic Science Vascular biology of plaque formation, vascular healing, reperfusion Platelet function and the clotting cascade, including drug effects Coronary anatomy and physiology flow dynamics, collaterals, perfusion Pharmacology Biologic effects and use of drugs vasoactive, sedatives, antiarrhythmics, etc Biologic effects of contrast agents Imaging Use of angiography and ultrasonography intravascular and intracardiac Radiation physics and radiation safety Miscellaneous Ethical issues and risks of diagnostic and therapeutic techniques Statistics, epidemiology, and economic issues of intervention Chapter 1: Cardiac Catheterization—History and Current Practice Standards TABLE 1.
Candidates able to pass this examination receive Board Certification via a Certificate of Additional Qualification in Interventional Cardiology. An example of the type of content tested in this exam is given in Table 1. At this writing, more than 4, interventional cardiologists have received the Certificate of Additional Qualification in interventional cardiology, which may soon include the performance of computer-simulated procedures for both training and certification.
On the other hand, several thousand individuals continue to perform interventional procedures without the benefit of such certification. As the field of interventional cardiology expands, it is increasingly recognized that knowledge and skill in coronary intervention does not necessarily confer the ability to safely perform peripheral vascular intervention.
Some content relating to peripheral vascular procedures is tested in the interventional exam, but individuals interested in performing complex lower extremity or carotid intervention are increasingly undertaking an additional training period after their interventional fellowship to gain the necessary skills and experience 55, Covers pre-catheterization evaluation, lab equipment, and pharmacology for the catheterization lab.
Outlines specific complications of cardiac catheterization, organized by disease, to prepare you for anything that may occur. Includes a bonus DVD containing videos of techniques that demonstrate what to look for and how to proceed, as well as a downloadable image library for use in electronic presentations. Uses a consistent, easy-to-follow chapter format that makes reference a snap. Presents illustrations for enhanced visual guidance.
This updated text addresses recent advances in structural heart interventions, in particular aortic and mitral valve procedures.
The advent of newer technologies presents both opportunities and challenges for the cardiologist to treat patients optimally. Interventional cardiologists are now at the forefront of peripheral and structural heart interventions. This new edition focuses on tailoring treatment to individual patients, taking into account specific risk factors and comorbidities, and appropriate use of devices.
This second edition also provides useful tools, such as treatment algorithms, evidence tables, charts, tables, and illustrations to enhance the value of this volume as a practical reference tool. The online edition also includes several "how-to" videos. Covers both the traditional diagnostic methods and the rapidly expanding diagnostic and therapeutic techniques developed over the past decade.
Peterson and Nicod, together with 22 expert contributors, highlight the best available clinical examples--helping readers to choose the most effective management options for their patients. Provides step-by-step guidelines for each procedure in the realm of right and left heart catheterization as well as cardiac and coronary angiography.
Delivers complete coverage of the following hot topics--the methods for studying pulmonary circulation, including pulmonary angiography and angioscopy, the catheterization and angiographic findings in the patient with pulmonary hypertension, and many more. Describes the basic components of a catheterization lab's radiographic systems--x-ray tubes, image intensifiers, cine-film cameras, video cameras, image archival devices and more--in easy-to-understand terms.
Surveys state-of-the-art therapeutic interventions, including plaque excisional atherectomy, rotational ablation, the emerging importance of coronay stent implantation, and more.
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