Cath lab

Introduction: This department, equipped with experienced specialists and physicians, provides rapid diagnostic and therapeutic procedures for cardiac diseases. The Cath Lab of Valiasr Hospital is located on the first floor, adjacent to the ICU OH and the cardiac operating room. In case of emergency surgery, it promptly coordinates with the operating room due to its proximity.

Direct Contact Numbers: 32122270-025 and 32122271-025

Head of the Department: Dr. Gholamreza Jalili

Supervisor: Ms. Faizeh Nayyar

Procedures Available in the Cath Lab:

• Right and left heart catheterization (adults)
• Coronary, central, and peripheral angiography (renal, lower limb arteries)
• Carotid and vertebral artery angiography
• Electrophysiological studies to determine arrhythmia sources
• EPS for investigating heart rhythm disorders and assessing cardiac blocks
• CRT, permanent and ICD, implantation of various types of single-chamber, dual-chamber, and three-chamber pacemakers, and temporary pacemaker insertion
• Emergency angioplasty in acute myocardial infarction

After diagnostic and therapeutic procedures in the Cath Lab, patients are transferred to Post-Cath or CCU based on the treating physician’s diagnosis.

Physicians’ Names:

• Dr. Saeed Salamat
• Dr. Gholamreza Jalili
• Dr. Masoud Muzaffari
• Dr. Abdollah Jafari
• Dr. Ali Badi
• Dr. Safieh Rezazadeh
• Dr. Mojtaba Yousefzadeh
• Dr. Mohammad Mahjourian
• Dr. Mohammadreza Asharinejad
• Dr. Hamidreza Neshat
• Dr. Alireza Bakhsi
• Dr. Ayoub Salehi
• Dr. Mostafa Rahimi Ardakani
• Dr. Elahe Yar Golabchi

Radiation Safety:
All radiological devices are annually checked for quality control in the department, and these devices hold quality control certification. The companies responsible are approved by the Atomic Energy Organization and hold legal licenses. The valid license for working with radiation is renewed every three years, and is available for review. To ensure safety, staff and patients are provided with lead aprons, lead caps, lead glasses, and lead necklaces, which are mandatory for use.

Admission Process:
During admission, the following is checked:

• Reviewing the patient’s file (physician’s order)
• Checking IV line, patient’s NPO status, and puncture site (thigh or radial artery) for appearance and pulse of extremities
• Checking and removing any artificial or ornamental devices
• Examining and controlling the drugs to be used for angiography and angioplasty (e.g., Plavix, Aspirin, Heparin, Coumadin, Warfarin)
• Gathering information about allergies and drug treatments
• Obtaining a history of kidney disease, diabetes, and sensitivity to contrast material
• Checking routine tests such as FBS, BUN, Cr, INR, PT, PTT, TG, and HIV
• Cardiac diseases, ABG, MI, and CVA (angiography, angioplasty) are also reviewed. The patient is then briefed on changing clothes, the prayer room, sanitary facilities, and the steps and procedures of catheterization. Patient education at this stage is particularly important.

Patient Transfer:

• Transfer to the Angiography Room and Patient Preparation:

The patient is transferred to the angiography table by stretcher or, if stable, by walking, and immediately undergoes ECG monitoring. The desired area (thigh or arm) is prepared and draped by the nurse. Essential actions are taken during catheterization as per the physician’s orders.

• Transfer to Recovery:

After the procedure, the patient is transferred to the recovery room. If only catheterization is performed, the arterial sheath is removed in recovery. If angioplasty is done, the arterial sheath is sutured and heparinized, after which the patient is transferred according to the physician’s order after checking PT and ACT.

• Transfer to the Ward:

Once the patient stabilizes, they are transferred to the Cath Lab ward with a stretcher, accompanied by the responsible nurse and a caregiver, with two bags of saline. The nurse checks the puncture site, peripheral pulses, ensures there is no bleeding from the puncture site, and checks for any hematoma. After ensuring the patient’s stability, they are transferred to the Post-Cath department.

Post-Angiography Care:

For Angiography Through the Arm:

• One hour after angiography, start with a liquid diet, and if tolerated, transition to a suitable diet.
• Do not leave the bed for two hours.
• For one week, keep the right hand elevated above the body if possible.
• Avoid lifting heavy objects or engaging in strenuous activities with the right hand for one week.

For Angiography Through the Leg:

• One hour after angiography, start with a liquid diet, and if tolerated, transition to a suitable diet.
• For the first 6 hours, avoid bending the leg and stay in bed. Use a sandbag for 3 hours.
• For one week, avoid driving, climbing stairs, bending the leg, and performing strenuous activities. Use a sitz bath.

Wound Care:

• Leave the dressing on the wound site for 24 hours.
• After 24 hours, remove the dressing and take a shower.
• If there is bruising and pain at the angiography site in the first 24 hours, use a cold compress. After 24 hours, switch to a warm compress.

Dietary Recommendations:

• Remain fasting for 2 hours after angiography.
• Always use a low-salt and low-fat diet.
• Smoking (cigarettes and hookah) is prohibited.

Home Care:

• In case of shortness of breath, chest pain, left shoulder pain, back pain, or heaviness/pressure in the chest, consult a doctor immediately.
• If there is bleeding, bruising, pain, or inflammation at the angiography site, consult a doctor.
• Reduce stress and anxiety.
• Continue taking heart medications as prescribed until the next consultation.

Time of Follow-up:

• Visit the doctor as soon as possible with the angiography documents.

Time for CD and Angiography Report Delivery:

• Visit the admission unit before 12 PM on the day after angiography to collect the CD and report.