Cath Lab Digest - October 2007 - (Page 52)

52 RESEARCH OCTOBER 2007 Recent data suggest that percutaneous closure of interatrial septal defect (IASD) is associated with a reduction in the intensity, frequency and duration of migraine headaches. population, improving patient outcome and prognosis. J INVAS CARDIOL 2007;19(5):229-233. JUNE 2007 Feasibility Study of Percutaneous Transvalvular Endomyocardial Cryoablation for the Treatment of Hypertrophic Obstructive Cardiomyopathy Keane D, Hynes B, King G, et al. Background. Left ventricular outflow tract (LVOT) obstruction in the setting of hypertrophic cardiomyopathy (HCM) confers negative adverse outcomes. Current nonpharmacologic treatment options include surgical myectomy and percutaneous transcoronary ablation of septal hypertrophy (TASH). While TASH negates a more invasive procedure, concern remains with particular regard to the arrhythmogenic potential of the resultant myocardial scar. Percutaneous transvalvular endomyocardial septal cryoablation (PTESC) may circumvent some of these potential limitations and offer a novel treatment strategy. Objectives. The purpose of this study was to report our early experience and outcomes with percutaneous endomyocardial cryoablation of the interventricular septum in obstructive HCM. Methods and Results. Between March 2005 and May 2006, 3 patients (2 male, 1 female) with DISCUSSION GROUP What Do You Think? Multiple new and ongoing questions from readers. Your responses are welcome! Answer or pose a question at cathlabdigest@aol.com. Re: Question Gauging Interest in Cardiology Physician Extender Program Dear Sir or Ma’am, I would definitely have an interest in the development of a cardiology physician extender program. I supervise a cath lab in an Army Medical Center, and I know that my staff, as well as other US Army Cath Techs, would be very much interested in any higher education they may receive pertinent this field. The Army is typically supportive of our efforts to further our education with tuition assistance for accredited programs, so please do forward what information you have, and note my personal interest, and the interest of many active duty Army cath techs in such educational opportunities. Respectfully, SGT Natalie R. Magee NCOIC, Cardiac Cath Lab Womack Army Medical Center Fort Bragg, North Carolina Program Update: Many discussions have been undertaken regarding the avenues of how this program might be developed. Several educators in the U.S. have expressed a sincere interest in the undertaking. The goal is pre and post management of patients; performing at least diagnostic procedures under the direct supervision of the physician-in-charge, and the intention is to offer a program that is 85% online, with 15% of the program requiring all students to be on campus for formal classes at least twice a semester. In addition, the intention is to offer a program that has a reasonable cost, since most candidates would have full-time positions, take call, and have families. Keep reading Cath Lab Digest over the next year for further details as the facts are presented. Thank you, Anonymous by request Email: cathlabdigest@aol.com Cc cathlabdigest@aol.com to have your response published in the next issue of Cath Lab Digest. New Questions Medication Errors I was wondering if anyone knows of any studies on medication errors in the cath lab and statistics involving the errors (i.e., nurses vs. techs, intervention vs. diagnostic). I was wondering who commits the most errors and during what situations the errors are committed. I feel this would help the lab where I work with calling attention to some areas where we may not always look (not that we have many errors at all). We have a lot of relatively young staff and we may be looking at crosstraining techs to give medications down the road. If you have heard of any studies or know of where I may be able to find this information, I would greatly appreciate it. Thank you, Mark Baker, MICP, RCIS Email: cathtech99@yahoo.com Cc: cathlabdigest@aol.com What is your department’s policy/ practice, and what level of the ACT is deemed safe for patients? Thank you. Mike LeGal, RN, BSN, CCRN Cardiovascular Lab Kaiser Sunnyside Hospital and Medical Center Clackamas, Oregon Email: Michael.R.Legal@kp.org Cc: cathlabdigest@aol.com Screening Criteria We are a small rural hospital with one diagnostic cath lab and two cardiologists. We have been unable to locate any up-to-date screening criteria (the most recent American College of Cardiology guidelines are dated 2001). What criteria would you recommend that we follow to screen our patients (inpatients and outpatients)? We do not offer bypass or interventional procedures. The closest facility is 30 minutes away. Thank you for your help. Sincerely, Cheryl J. Harrell, RN and Lori A. McMahon, RN Provena United Samaritans Medical Center Email: Cheryl.Harrell@provena.org Cc: cathlabdigest@aol.com ACT Check Prior to Sheath Pull Our cath lab is currently reviewing and writing policies and procedures. We are currently reviewing standards for pulling arterial sheaths when heparin has been given as a bolus prior to a diagnostic procedure or during a peripheral intervention. Currently, there is no practice in place to check an ACT unless the physician orders it. Our Policy and Procedure Committee wants to implement a policy for checking an ACT prior to pulling the sheath. RCIS Mandatory? We are thinking of making it mandatory for our staff to be RCIS-certified. Are there labs that have done this? What has been your process to implement this change? Anonymous Email: cathlabdigest@aol.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - October 2007

Saints Medical Center Fibromuscular Dysplasia in Children and Adolescents Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale Contents Clinical Editor’s Corner Meetings Calendar CEU Education Center Radiation Tracking in the Cardiac Catheterization Lab Letter to the Editor Carotid Stenting: An update Release from Stent-jail: Beneficial Snow-Plowing? Patient Management Guidelines Searching for a Cardiovascular Position? Tips for Creating a ‘Stand-Out’ Resume Long-Term Implications of Short-Term Closure Decisions – The Evolution to Vascular Access Management and the Boomerang Catalyst System The Ten-Minute Interview with… Angie Bowles, RN, CCRN CMS Issues Final FY 2008 IPPS Rule ACVP• Membership Page Experience with a New Workhorse Guidewire Ask the Clinical Instructor: Q&A for Those New to Cath Lab A Glimpse of the Future of Clinical Education: Boston Scientific’s SimSuite Bus Visits Carnegie Institute 2007 Educational Fair Held at the Washington Hospital Center Research Update: Original Contribution Abstracts from The Journal of Invasive Cardiology What Do You Think? A Virtual Cath Lab Viewer (VCL): The Development of an Online 3D C-arm Simulator and Coronary Anatomy Viewer Clinical & Industry News Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization

Cath Lab Digest - October 2007

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