Cardiac catheterization laboratory: Cardiac catheterization laboratory is the place where angiography and angioplasty is done. It is an operation theatre like sterile facility equipped with cine X-ray (fluoroscopy) equipment. It is also called cath lab as a short name. Blood vessels and chambers of the heart can be imaged with the equipment after injecting iodinated radiocontrast ‘dye’ into the various blood vessels.
What is the most important work done in cath lab these days?
Most important procedure in the cath lab is primary angioplasty. For this the cath lab services have to be available round the clock. Primary angioplasty is removal of blocks in the blood vessels of the heart in a victim of heart attack. To be most effective, it has to be done as early as possible. The longer the delay, the more the damage to the heart muscle and immediate and long term problems.
In some centres there is a direct link between the emergency department and the cath lab. When a person with heart attack arrives in an ambulance, if the cath lab team is ready, a green light will be displayed in the emergency department. For this to work well, the ambulance team should have taken the ECG of the heart attack victim and transmitted to the receiving hospital beforehand. If the cath lab is ready, the person is transferred from the ambulance directly to the cath lab, bypassing the emergency department. This saves time which is otherwise spent for receiving in the emergency department and triaging followed by further transport to the cath lab.
What other work is done in the cardiac catheterization laboratory?
Though primary angioplasty is the most important life saving procedure done in the cath lab, most cath labs have a lot of other work. It is useful for a wide range of procedures for the heart, brain and other organs. Diseases of blood vessels anywhere in the body can be addressed using cath lab facility. The diagnostic test for blood vessels is known as angiography. Treatment procedure for blood vessels could be removal of blocks (angioplasty) or insertion of mesh like tubes (stents). When an abnormal vessel is bleeding or producing other problems, it can be closed off by a process known as embolization. In this small coils, gel foam or PVC particles are deposited carefully in the target vessel to occlude it. It is a life saving procedure in some types of severe bleeds.
Specialized devices for the heart like pacemaker, implantable cardioverter defibrillator, cardiac resynchronization therapy (heart failure device) are implanted from the cath lab.
What is a hybrid cath lab?
Some procedures can be better done by a close coordination between the surgeon and the physician. A hybrid cath lab is one in which a true operating room facility is also available along with cath lab facility. Of course, such a facility is much more costlier than a cath lab alone. It also comes in handy when an emergency surgical bailout is needed after an invasive procedure which develops some life threatening complication.