What type of procedures are performed at your facility?

Our cath lab performs diagnostic and interventional procedures. Diagnostic cases include left and right heart cardiac catheterizations, Swan Ganz insertions, coronary and peripheral intravascular ultrasound (IVUS), WaveWire (Volcano Therapeutics Inc., Rancho Cordova, CA), peripheral studies, as well as carotid and cerebral angiograms. Interventional procedures include angioplasty, stenting, rotational atherectomy, thrombectomy, intra-aortic balloon pump (IABP) insertions, pacemaker insertions, pericardiocentesis and percutan

What is the history and purpose of the SINCERE database?

I was the director of the cardiovascular laboratory at Cedars Medical Center in Miami for about 9 years. Early in that tenure, before it became common, I had begun to perform acute myocardial infarction (MI) interventions. This was in 1994, during the days of the Johnson & Johnson Palmaz-Schatz stent. It was some of the earliest experience of stenting for acute MI. Over the next few years, I performed 137 primary stenting procedures with f
airly good outcomes. Unfortunately, I never documented those procedures as well as I sho

Reprinted with permission from The Journal of Invasive Cardiology 2007;19:20-24.

This article can be found in full online at: http://invasivecardiology.com/article/6626

In fairness to the interventionalist above, he was concerned that the additional contrast and the performance of an LV gram in this setting was unnecessary and possibly harmful. I disagree. From our subsequent discussions, it was apparent that in recent years operators have come to omit left ventriculography from both routine and emergency catheterizations for several reasons: 1) Prior echo assessment of the LV; 2) Concern for extra contrast load; 3) Fear of hypotension or other complications of ventriculography; 4) Extra time needed to perform the LV gram. With specific exceptions, I do not b

What is a meta-analysis?

A meta-analysis is a statistical technique that allows multiple, independent studies to be combined and analyzed. A meta-analysis uses data that is available to the public, usually in manuscript form, although this information can come from abstracts that have been presented at scientific meetings prior to the publication of a study. A patient-level meta-analysis, or pooled analysis, is different. A patient-level meta-analysis takes the original data from each trial and each patient. This requires cooperation from each of the studies' principal primary invest

Definitions of turnaround times

Today, there are several definitions of turnaround times in use at different facilities. The two most common are measurements of the time from: a) when one patient leaves a procedure room until the time the next patient enters the same room; b) when the physician leaves the procedure room until the time the next physician presents himself in that same room.

Each methodology has its pros and cons. For example, the patient-centered definition does not take into account physician wait times. The physician-centered definition takes the physician wait t

The cardiovascular industry is still booming, and the future looks bright for many years to come. In fact, despite reimbursement challenges and increasing competition, a cardiac and vascular program can contribute 20-40% of a hospital's revenue, which is why this specialty is an area where effective leadership can bring the most dramatic results.

We've also been witness to a paradigm shift. With increasing numbers of advanced-service programs opening in communities across the country, the demand for qualified clinical, administrative, and physician leaders to oversee these programs has ri

In the previous issue, we touched upon the no or slow reflow phenomenon sometimes seen in acute myocardial infarctions (AMIs) and angioplasty. Your question is indirectly related to our July discussion of that phenomenon (available online at www.cathlabdigest.com).

TIMI stands for Thrombolysis In Myocardial Infarction. The TIMI Study Group is an organization that engages in evaluation of different angiographic issues, trials and studies. The organization began in 1984, with a study called TIMI 1, to compare the reperfusion rates between streptokinase and t-PA. Since then, this group has s

I have been in Alaska for 9 months. Anchorage is an amazing city, almost as amazing as the state of Alaska. I have never seen a city with so many municipal grounds. The trails in the city are more beautiful than any I've ever seen. I can drive 50 miles to a glacier for a hike, 250 miles to Denali park, surrounding the highest peak in North America (Mt. McKinley). I have pictures of a moose in my backyard. The outdoor activities are all year long. A little snow and ice does not stop Alaskans from living the Big Wild Life.

Why did you choose to work in the invasive cardiology field?

Suddenly, the phone rang. It was the emergency room (ER) calling. A patient was having an acute myocardial infarction (MI) in the ER and needed intervention immediately. Upon hearing this information, our team went into overdrive without a moment’s hesitation. Part of the crew went to the ER to get the patient, while the rest of us prepared the procedure room, set up the monitoring equipment, looked up lab and other results and then waited. The minutes ticked by like hours. The anticipation of the patient and the frustration of not knowing what was happening had reached its peak when the cat