Cardiac catheterisation laboratory – cathlab

Cardiac catheterisation laboratory – cathlab

Cardiac catheterisation laboratory or cathlab, is a comprehensive setup used for diagnostic and therapeutic cardiac catheterisation. The most important equipment in the cathlab is the x-ray image intensifier system. The X-ray tube is a heavy duty one generating about 1000 mA of tube current and capable of continuous operation. In the fluroscopic mode, the current will be much smaller, in the order of a few millamperes, while in cine mode the currents are high, of the order of 600 – 800 mA. Operating voltage is in the range of 70 – 100 Kilovolts.

X-ray tube generates the X-rays needed for imaging. It is not visible in the picture, being below the table and behind the lead shield. The X-ray beam passes through the flurosopic table and the patient positioned on the table and is received by the image intensifier, to produce the images. The X-ray tube is operated using foot pedals, by the operator. The X-ray tube and the image intensifier are attached to a C-arm gantry which can be rotated in two planes to produce various angulated views, typically operated by the assissting cathlab technician. Fluoroscopic table can also be moved for positioning during imaging. The images are seen on the fluroscopic monitor which is suspended from the ceiling. The cine images are also recorded by the computerised recording system for archival. The videos can be recorded on to a CD or DVD.

An invasive pressure monitor with facility for monitoring intracardiac pressures and ECG, pressure injector, intra aortic balloon pump, cardiac monitor defibrillator, infusion pumps, suction apparatus and other supporting equipment are part of the gadgets available in the cathlab. A pressure injector is needed for injecting contrast media in a graded fashion at adjustable speeds and volumes.

Radiation protection devices are mandatory when you work in the cathlab. The patient table has lead shields on the sides to minimize scatter radiation from the X-ray generator. A movable glass shield is positioned between the operator and the image intensifier. Personnel inside the cathlab wear full radiation protection gear including lead apron, thyroid shield, lead goggles and radiation protection cap. Radiation monitoring badge is also used to assess the cumulative monthly dose. Appropriate patient protection is also given.