Cardiac Angiography (Cath Lab) Department

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. These devices have quality control certification. It should be noted that these companies are approved by the Atomic Energy Organization and have legal licenses. The valid license for working with radiation is renewed every three years in the department and is available. Lead protection for staff and patients includes lead aprons, lead caps, lead glasses, and lead necklaces, and personnel are required to use them.

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) in terms of appearance and pulse of the extremities
• Checking and removing any artificial or ornamental devices
• Examining and controlling the drugs received for angiography and angioplasty procedures, such as Plavix, Aspirin, Heparin, Coumadin, and Warfarin
• Information about any 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, CVA (angiography, angioplasty)

Then, the patient is briefed on changing clothes, prayer room, sanitary facilities, and the steps and procedures of catheterization. Patient education at this stage is of special importance.

Patient Transfer:

• Transfer to the Angiography Room and Patient Preparation:

The patient is transferred to the angiography table by stretcher or, if not a problem, by walking and immediately undergoes ECG monitoring. The desired area (thigh or arm) is prepared and draped by the nurse. Essential actions according to the physician’s order are taken during catheterization.

• Transfer to Recovery:

After completing 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 performed, the arterial sheath is sutured and heparinized, and then it is transferred according to the physician’s order after checking PT and ACT.

• Transfer to the Ward:

After the patient stabilizes, along with the responsible nurse and a caregiver, the patient is transferred to the Cath Lab ward with a stretcher and two bags of saline. The nurse checks the puncture site, peripheral pulses, absence of bleeding from the puncture site, and the presence of hematoma in the patient. After ensuring the stability of the patient, 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, a suitable diet begins for the patient.
• Do not leave the bed for two hours.
• For one week, keep the right hand higher than the body if possible.
• Avoid lifting heavy objects with the right hand and performing strenuous activities for one week.

For Angiography Through the Leg:

• One hour after angiography, start with a liquid diet, and if tolerated, a suitable diet begins for the patient.
• For the first 6 hours after angiography, avoid bending the leg and do not leave the bed. Use a sandbag for 3 hours.
• Avoid driving, going up and down stairs, bending the leg, and performing strenuous activities as much as possible for one week. Use a sitz bath.
• 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 in the angiography site in the first 24 hours, use a cold compress, and after 24 hours, use 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, and a feeling of heaviness and pressure in the chest, consult a doctor.
• In case of bleeding, bruising, pain, and inflammation at the angiography site, consult a doctor.
• Reduce stress and anxiety.
• Continue taking heart medications as usual until seeing the doctor.

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 for CD and report delivery.