Heart Catheterisation and Invasive Cardiology (RKA_031)
About Study Course
Objective
The course is designed for cardiology residents to acquire theoretical knowledge, practical skills and competencies about modern invasive examination and treatment methods of cardiovascular diseases: coronary angiography, intravascular ultrasonoscopy (IVUS), virtual histology (VH), determination of fractional flow reserve (FFR), waveless moment coefficient ( iFR), optical coherence tomography (OCT), left and right heart catheterization, angiography and pressure measurement, angiography of trunk and other large vessels (brachiocephalic arteries, aorta, renal arteries, pelvic and leg arteries, etc.), percutaneous transluminal coronary angioplasty (PTCA ) with balloon (POBA) and stent implantation, stenting of arteries of other basins, invasive diagnosis and treatment methods of acquired and congenital heart defects, invasive cardiomyopathy treatment methods, acute heart failure (cardiogenic shock) invasive treatment methods and auxiliary devices, myocardial biopsy.
Learning outcomes
1.- Nature, indications, contraindications, advantages and disadvantages of invasive methods used in cardiology;
- Proper preparation of the patient for invasive cardiology examinations, their possible complications and timely prevention of complications;
- Effects of contrast agents, side effects caused by them, their prevention and management;
- Indications for catheterization of the right and left sides of the heart, coronary angiography and angiography of other locations;
- Indications for diagnostic and therapeutic percutaneous coronary intervention;
- Indications for invasive radiological examination methods in patients with cardiovascular pathology;
- Indications for surgical treatment of coronary heart disease;
- Principles and safety rules of radiological imaging, radiation physics, radiation exposure;
- Catheterization laboratory equipment (physiological monitoring, locks, probes, blood gas analyzers, injector, etc.);
- Radiological anatomy of the heart, aorta, large vessels, coronary arteries, as well as femoral, radial and brachial arteries to ensure vascular access during catheterization;
- Collection of hemodynamic and oximetric data and their application to determine cardiac output, vascular resistance, valve area and shunts;
- Interpretation of pressure waves, hemodynamic and oximetric data;
- Vascular access techniques and sites;
- Types of catheters used in cardiac catheterization and coronary angiography;
- Trans-septal cardiac catheterization;
- Basic principles of intracoronary ultrasound (intravascular ultrasonoscopy, IVUS), Doppler, coronary artery pressure measurement (FFR) and optical coherence tomography.
- Complications of cardiac catheterization and angiography and their treatment.
1.- Analyze parameters of invasive hemodynamics;
- Create aortic balloon counterpulsation and other percutaneous circulation auxiliary device systems;
- Optimize the use of equipment to reduce radiation exposure in order to protect the patient and the catheterization team, as well as reduce the use of nephrotoxic contrast agents;
- Obtain arterial (femoral, radial, brachial) and venous access, as well as ensure hemostasis after catheterization;
- Perform catheterization of the left parts of the heart, including coronary angiography, ventriculography, aortography, as well as coronary and mammary artery shunt angiography;
- Perform catheterization of the right part of the heart in the catheterization laboratory and at the patient's bedside, as well as measure cardiac output, intra-vascular pressure and oxygen saturation;
- Manage life-threatening arrhythmias and other emergencies in the catheterization laboratory;
- Evaluate normal and abnormal coronary angiograms, ventriculograms, aortograms and pulmonary angiograms;
- Interpret hemodynamic and oximetric data;
- Apply additional pharmacological therapy safely and according to the situation.
1.- Interpretation of data obtained from measurements of invasive hemodynamic parameters;
- Monitoring of the aortic balloon counterpulsation system and other percutaneous circulatory support systems;
- Interpretation of the results of invasive cardiovascular radiological examinations.
