Percutaneous Closure of Postmyocardial Infarction Ventricular Septal Defect

Anesthesia in the cardiac catheterization laboratory and electrophysiology laboratory

Procedures and interventions in the cardiac catheterization laboratory (CCL) and electrophysiology laboratory (EPL) are more complex and involve acutely ill patients. Safely caring for this growing patient population in the CCL and EPL is now a concern for all anesthesiologists and cardiologists. Anesthesiologists are uniquely trained to care for this complex patient population, allowing the cardiologist to focus on completing the interventional procedure successfully.

Offsite anesthesiology in the cardiac catheterization lab

PURPOSE OF REVIEW

The cardiac catheterization lab has concerns for both patient care and for safety. As the cardiac catheterization lab continues to evolve, the demand for anesthesia services will certainly increase. The role of the anesthesiologist in the cardiac catheterization lab must be defined in this changing environment.

RECENT FINDINGS

Procedures in the cardiac catheterization lab are more complex, take longer, and involve higher acuity patients. Many of these cases require general anesthesia rather than sedation, and require management of unstable hemodynamics. Knowledge of echocardiography and fluoroscopy is beneficial. Anesthesiologists should be active in developing sedation and practice management guidelines. Radiation exposure and safety is an important concern.

SUMMARY

The anesthesiologist is becoming an integral part of the cardiac catheterization lab team, and an important element in maintaining a high level of patient care with minimal complications in the evolving modern day cardiac catheterization lab.