Sample Report Cardiac Catheterization
Title of Procedure
1. Left heart catheterization.
2. Coronary angiography.
3. Left ventriculography.
4. Saphenous vein graft angiography.
5. Left internal mammary graft angiography.
Procedure in Detail: After informed consent was obtained and premedications administered, the area of the right femoral triangle was prepped and draped in the usual sterile fashion. Xylocaine 1% was used for local anesthesia. Modified Seldinger technique was used to place a 6 French Hemaquet in the right femoral artery. Using standard Judkins technique with a JL4 and JR4, left followed by right coronary angiography was performed in multiple right anterior oblique and left anterior oblique views. The right coronary catheter was used for angiography of the internal mammary. A multipurpose catheter was used for right coronary artery saphenous vein graft angiography. Finally, a pigtail catheter was used for left ventriculography performed in the 30-degree RAO view. VasoSeal was used for hemostasis. The patient tolerated the procedure well. There were no complications.
The patient remained in a sinus rhythm. Left ventricular end-diastolic pressure was 16. There was no gradient between the left ventricle and aorta on pullback. Left ventriculography revealed mild global hypokinesis but low normal left ventricular systolic function.
Coronary Angiography: Injection of the left coronary system demonstrates a left main which trifurcates into a LAD, ramus, and circumflex. Left main has a concentric 60%—70% distal narrowing involving the trifurcation of the LAD, ramus and circumflex. There is no damping or ventricularization with catheter engagement.
The LAD is a fair-caliber vessel which gives rise to a moderate-sized proximal diagonal and multiple septal perforating branches, and the LAD terminates just at the inferior aspect of the left ventricular apex. There is competitive spilling from the mid to distal LAD via the internal mammary bypass. The mid to distal LAD is widely patent and of fair caliber. There is luminal irregularity in the proximal LAD with no obstructive lesions. Likewise, the first diagonal has diffuse irregularity but no obstructive disease.
The ramus is of smaller caliber and free of obstructive disease.
The right coronary artery is dominant and completely occluded near its origin.
Saphenous Vein Graft to the Posterior Descending Artery: This graft is widely patent, briskly filling a fair-caliber PDA and a larger posterolateral system. There is some mild luminal irregularity, but no obstructive disease in this system.
1. Left heart catheterization.
2. Coronary angiography.
3. Left ventriculography.
4. Saphenous vein graft angiography.
5. Left internal mammary graft angiography.
Procedure in Detail: After informed consent was obtained and premedications administered, the area of the right femoral triangle was prepped and draped in the usual sterile fashion. Xylocaine 1% was used for local anesthesia. Modified Seldinger technique was used to place a 6 French Hemaquet in the right femoral artery. Using standard Judkins technique with a JL4 and JR4, left followed by right coronary angiography was performed in multiple right anterior oblique and left anterior oblique views. The right coronary catheter was used for angiography of the internal mammary. A multipurpose catheter was used for right coronary artery saphenous vein graft angiography. Finally, a pigtail catheter was used for left ventriculography performed in the 30-degree RAO view. VasoSeal was used for hemostasis. The patient tolerated the procedure well. There were no complications.
The patient remained in a sinus rhythm. Left ventricular end-diastolic pressure was 16. There was no gradient between the left ventricle and aorta on pullback. Left ventriculography revealed mild global hypokinesis but low normal left ventricular systolic function.
Coronary Angiography: Injection of the left coronary system demonstrates a left main which trifurcates into a LAD, ramus, and circumflex. Left main has a concentric 60%—70% distal narrowing involving the trifurcation of the LAD, ramus and circumflex. There is no damping or ventricularization with catheter engagement.
The LAD is a fair-caliber vessel which gives rise to a moderate-sized proximal diagonal and multiple septal perforating branches, and the LAD terminates just at the inferior aspect of the left ventricular apex. There is competitive spilling from the mid to distal LAD via the internal mammary bypass. The mid to distal LAD is widely patent and of fair caliber. There is luminal irregularity in the proximal LAD with no obstructive lesions. Likewise, the first diagonal has diffuse irregularity but no obstructive disease.
The ramus is of smaller caliber and free of obstructive disease.
The right coronary artery is dominant and completely occluded near its origin.
Saphenous Vein Graft to the Posterior Descending Artery: This graft is widely patent, briskly filling a fair-caliber PDA and a larger posterolateral system. There is some mild luminal irregularity, but no obstructive disease in this system.
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