Cardiac Catheterization Rotation


interventional_200

Training in Cardiac Catheterization takes place at both UAB Hospital and the Birmingham VA Medical Center (BVAMC). Cardiology Fellows are assigned to the UAB Cardiac Catheterization Laboratory for several months during their first year of clinical training and to the BVAMC Cardiac Catheterization Laboratory during their second and third year of clinical training.


Director

Massoud Leesar, MD

Faculty

Brigitta Brott, MD
Massoud Leesar, MD
Silvio Papapietro, MD
Mark Sasse, MD

Patient Population

Patients needing further diagnoses of coronary artery disease, valvular heart disease, congestive heart failure, and/or certain congenital heart conditions, such as atrial septal defect or ventricular septal defect, when other less invasive types of diagnostic tests indicate the presence of one of these conditions.

Clinical Responsibilities

  • See all patients prior to the scheduled catheterization
    • perform a history and physical exam
    • review relevant laboratory work and results of previous non-invasive and invasive imaging procedures
    • document this evaluation in the progress note section of the medical chart (this note must be detailed)
  • Discuss the planned procedure in detail with the responsible attending.
    • review indications and potential contra-indications for the procedure
    • plan the procedural approach
  • Discuss the planned procedure with the patient and family members and obtain informed consent.
  • Perform the procedure under direct supervision of the cardiology attending.
  • Review outcomes (attending and Cardiology Fellow jointly)
    • read the digital images
    • review relevant hemodynamic tracings together
    • discuss management options
  • Accurately summarize the findings of the procedure in a catheterization report (processed in a timely fashion) and communicate results to:
    • other members of the Healthcare Team
    • patients
    • families (as deemed appropriate by the attending)
  • Write post-catheterization orders.
  • Perform a post-procedure exam to rule out potential procedure-related complications.
  • Document the post-procedure exam in a progress note in the chart.
  • Present interesting cases at
    • monthly Wednesday cardiac catheterization conferences
    • bi-weekly Tuesday cath case conferences (along with corresponding literature review)

Essential Skills

  • Performing and interpreting
    • right and left heart catheterization coronary, graft and ventricular angiography
    • hemodynamic assessment endomyocardial biopsies
  • Obesrving and understanding
    • peripheral and cerebrovascular procedures
    • renal angiography and intervention
  • Interpreting
    • intracoronary IVUS tracings
    • coronary flow and pressure measurements (with and without vasodilator challenge)

Educational Outcomes

Cardiologists successfully completing this rotation will be proficient in:

  1. Pre-procedure evaluation and post-procedure follow-up of patients with a wide variety of cardiovascular diseases and co-morbidities.
  2. Performing and the interpretating right and left heart catheterization coronary, graft and ventricular angiography hemodynamic assessment.
  3. Performing endomyocardial biopsies and understanding the indications, contra-indications, and potential benefits and risks of these procedures.