Complication Management In The Cardiac Catheter Laboratory

Foreword I
Foreword II
Preface to the Second Edition
Preface to the First Edition
Acknowledgements
Contents
About the Editor
List of Authors
List of Editor and Authors
I: Before the Cardiac Catheterization Laboratory
1: Examination and Treatment Planning
1.1 Patient Preparation
1.1.1 Introduction
1.1.2 Standards for the Performance of Diagnostic Coronary Angiography and Elective Coronary Interventions
1.1.3 Standards for the Performance of Emergency Interventions
1.1.4 Selection and Preparation of the Access Route
1.1.5 Examination Under Anticoagulation
1.1.6 Use of Checklists in the Cardiac Catheterization Laboratory
1.2 Legal Aspects of Patient Information
1.2.1 Introduction
1.2.2 Contents of the Enlightenment
1.2.3 Risk Disclosure
1.2.4 Intervention-Specific, Typical Risks
1.2.5 Risk Medication Consent
1.2.6 Treatment Alternatives
1.2.7 New Medical Territory
1.2.8 Timing of Informed Consent
1.2.9 Emergency Informed Consent
1.2.10 Formal Criteria of Informed Consent
1.2.11 Informed Consent by Telephone Permissible?
1.2.12 Safeguarding Information or Therapeutic Information and Economic Information
1.3 Conclusion
References
II: In the Cardiac Catheterization Laboratory
2: Procedural Complications
2.1 Puncture Site Related Complications
2.1.1 Femoral Access Route
2.1.2 Radial Access
2.2 Aortic Complications
2.2.1 Epidemiology
2.2.2 Complications in the Area of the Infrarenal Aorta
2.2.3 Complications in the Area of the Landing Zone/Ascending Aorta
2.2.4 Kinking of the Aorta
2.2.5 Aortic Aneurysms
2.3 Complications During Catheter Placement
2.3.1 History of Medicine
2.3.2 Dissections
2.3.3 Arrhythmias and Hypotension
2.3.4 Perforations and Tamponade
2.3.5 Selection of the Guide Catheter
2.4 Complications of Coronary Wire Placement
2.4.1 Properties of Coronary Wires
2.4.2 Coronary Perforation by the Coronary Wire
2.4.3 Coronary Dissection by the Coronary Wire
2.4.4 Wire Rupture in the Coronary Vessel
2.5 Complications of Balloon Dilatation
2.5.1 Introduction
2.5.2 Balloon Angioplasty Alone, POBA
2.5.3 Success Rate of Balloon Angioplasty
2.5.4 Dissections After Balloon Angioplasty
2.5.5 Restenosis After Balloon Angioplasty
2.5.6 Vascular Occlusions After Balloon Angioplasty
2.5.7 Coronary Perforation After Balloon Angioplasty
2.5.8 Need for Bypass Surgery After Balloon Angioplasty
2.5.9 Dilatation of Ostial Stenoses and Bifurcation Stenoses
2.5.10 Dilatation of Long Stenoses
2.5.11 Dilatation of Bypass Stenoses
2.6 Complications of Stent Implantation
2.6.1 Stent Loss
2.6.2 The Non-dilatable Stent
2.6.3 Vessel Rupture During Stent Implantation
2.6.4 Edge Dissection
2.6.5 Closure of Side Branches
2.6.6 Distal Embolization and No Reflow
2.6.7 Stent Thrombosis
2.7 Thromboembolic Complications and Thrombus Management
2.7.1 Pathophysiology
2.7.2 Prognosis
2.7.3 Pharmacological Therapy of Thromboembolic Complications
2.7.4 Manual Thrombus Aspiration
2.7.5 Mechanical Thrombus Aspiration
2.7.6 Distal Protection
References
3: Periprocedural Complications
3.1 Contrast Media Induced Allergy
3.1.1 Clinical Presentation
3.1.2 Prophylaxis of Contrast Agent Incidents
3.1.3 Management of Severe Contrast Reaction
3.1.4 Examination in Latent and Evident Hyperthyroidism
3.2 Contrast-Induced Nephropathy
3.2.1 Definition and Incidence
3.2.2 Pathogenesis
3.2.3 Prophylaxis and Therapy
3.3 Hemodynamic Instability and Circulatory Management
3.3.1 Monitoring in the Cardiac Catheterization Laboratory
3.3.2 Bradycardic Arrhythmias
3.3.3 Tachycardic Arrhythmias
3.3.4 Cardiogenic Shock: Causes, Diagnosis and Therapy
3.4 Airway Management in the Cardiac Catheterization Laboratory
3.4.1 Introduction
3.4.2 Endotracheal Intubation
3.4.3 Supraglottic Airway Support, Laryngeal Tube
3.4.4 Video Laryngoscopy
3.4.5 Sedation in the Cardiac Catheterization Laboratory
3.5 Cardiopulmonary Resuscitation in the Cardiac Catheterization Laboratory
3.5.1 General Remarks and Strategy of CPR in the Cardiac Catheterization Laboratory
3.5.2 Defibrillation Strategy in the Cardiac Catheterization Laboratory
3.5.3 Technical Equipment
3.5.4 Staffing
3.5.5 Typical Triggers of Resuscitation Situations in the Cardiac Catheterisation Laboratory
References
Further Reading
4: Error Management
4.1 What Can We Learn from Aviation?
4.1.1 Introduction
4.1.2 History of the Development of Human Factors Training
4.1.3 The Five Evolutionary Stages of Crew Resource Management
4.1.4 Legal Basis and Guidelines for CRM Training
4.1.5 Scope and Content of Human Factors Training Courses
4.1.6 The Assessment of Behavioural Performance in Aviation
4.2 Transferability of Human Factors Concepts from Aviation to Medicine
4.2.1 Crisis Resource Management (CRM) Seminars
4.2.2 CRM in Medical Education and Training
4.2.3 The Importance of Simulation for CRM in Medicine
4.2.4 The Evaluation of Behavioural Performance in the Context of Crisis Resource Management
4.2.5 Error Culture Versus Blaiming Culture
4.2.6 Influences on the Implementation of CRM from the Aviation Perspective
4.2.7 Routine Situation Versus Incident
4.2.8 Team and Interfaces
4.2.9 Aviation: A Perfect Example of CRM?
References
Further Reading
5: Error Management in Interventional Cardiology
5.1 Education and Training Situation in Interventional Cardiology
5.2 Optimization of Procedural and Periprocedural Complication Management in the Cardiac Catheterization Laboratory
5.2.1 Technical Skills Training
5.2.2 Non-technical Skills Training, Emergency Management
5.3 Outlook
References
Further Reading
III: After the Cardiac Catheterization Laboratory
6: Patient Follow-Up
6.1 Removing the Intra-arterial Sheath and Closing/Pressing the Puncture Site
6.1.1 Access via the Groin, Puncture of the Common Femoral Artery
6.1.2 Access via the Arm, Puncture of the Radial Artery
6.2 Monitoring After Coronary Angiography and Coronary Intervention
6.3 Outpatient Follow-Up Examinations After Cardiac Catheterisations
6.4 Conclusion