Post-CCU (Cardiology Department)

Introduction to the Department: The Cardiology Department is located on the first floor, adjacent to CCU2. It consists of 7 rooms and 17 beds, including:

• 4 two-bed rooms
• 3 three-bed rooms

Each room is equipped with:

• Central oxygen
• Central suction
• Cardiac monitoring
• Television

Direct Contact Numbers: 32122314-025 and 32122315-025

Head of the Department: Dr. Gholamreza Jalili

Department Supervisor: Marzieh Fateh

Medical Team
Cardiac Surgeons:

• Dr. Naser Kachouyan
• Dr. Seyed Mojtaba Mirhosseini Mousavi

Cardiologists:

• Dr. Gholamreza Jalili
• Dr. Ali Badi
• Dr. Saeed Salamat
• Dr. Masoud Mozafari
• Dr. Safieh Rezazadeh Lavaaf

Post-Angiography and Angioplasty Procedures For Angiography Patients:

1. Transfer to Cath Lab: Patients are transferred via wheelchair after pre-angiography preparations.
2. Femoral Angiography:
   – After sheath removal, two sandbags are placed on the angiography site.
   – The patient is transferred back to the department via wheelchair.
   – Leg must remain straight (bending is strictly prohibited).
   – Vital signs and bleeding site are checked regularly.
   – Sandbags remain in place for 6 hours, then removed once bleeding is ruled out.
   – Food intake is allowed 2 hours after angiography.
   – ECG is performed based on the physician’s order.
   
   

3. Radial Angiography:
   – A TR band is applied to the wrist to control bleeding.
   – The band is gradually deflated by the clinical nurse every 20 minutes.
   – Once bleeding is ruled out, the band is fully removed.
   – The patient can eat 30 minutes after arrival at the department.
   – The patient must avoid bending or applying pressure to the wrist.

For Angioplasty Patients:

1. Patients are transferred to the Post-Cath (P.CCU or CCU) department with the femoral sheath in place.
2. The clinical nurse receives the patient from Cath Lab and checks:
   – Femoral or radial pulse
   – Oxygen saturation (for radial angiography)
   – Signs of bleeding
3. Angioplasty patients typically return to the Cardiology Department after 24 hours.
4. If stable, they are monitored for an additional 24 hours before discharge.

Preoperative Routine for CABG (Coronary Artery Bypass Graft) Patients
Pre-Surgery Preparations:

1. Routine blood tests, including: CBC, ESR, PT, INR, BUN, Cr, FBS, Lipid Profile, Liver Function Tests, Coagulation Profile, and others
2. ECG (Electrocardiogram)
3. Blood product reservation (Platelets & FFP – at least 2 units each)
4. Chest X-ray
5. Informed consent from the patient and companion
6. Full-body shaving
7. Angiography CD & report attachment
8. Carotid Doppler ultrasound (for patients over 60, if ordered)
9. Specialist consultations (endocrinology, pulmonology, nephrology, etc.)
10. Cardiac anesthesia consultation
11. Medication management:
    – Aspirin stopped 5 days before surgery
    – Plavix stopped 7 days before surgery

    – Heparin stopped one dose before surgerysurgery

12. Right-hand IV line placement
13. For patients on Warfarin (e.g., for valve replacement):
    – Warfarin is discontinued
    – Heparin or Clexane is started as per the physician’s order
14. NPO (nothing by mouth) for 8 hours before surgery

Postoperative Routine for Heart Surgery: After open-heart surgery, the patient is initially admitted to the ICU OH for up to 4 days, then transferred to the Cardiology Department.

Post-Surgery Monitoring & Care:

• Vital signs monitoring
• Arrhythmia monitoring
• Central Venous Pressure (CVP) line monitoring
• Consciousness assessment
• Urine output monitoring
• Surgical site inspection (for bleeding or abnormal discharge)
• Pressure ulcer prevention and skin integrity checks