NURSES

RESPONSIBILITIE
S IN
INTERVENTIONA
L CARDIOLOGY
PRESENTED BY:
H. RUFUS RAJ
LECTURER

ALSHIFA COLLEGE OF NURSING

 DEFINITION
Interventional cardiology is
a branch of the medical specialty
of cardiology that deals
specifically with the catheter
based treatment of structural
heart diseases.

-Wikipedia.Com
 ADVANTAGES OF
INTERVENTIONAL CARDIOLOGY
Ø Avoidance of the scars, pain, and
long postoperative recovery
associated with surgery
Ø Accessibility of the artery in most
patients
Ø Easy control of bleeding even in
anticoagulated patients
Ø Enhancement of comfort because
patients are capable of sitting up
and walking immediately following
the procedure.
ANGIOPLASTY
Angioplasty
Also called percutaneous transluminal coronary
angioplasty (PTCA), angioplasty is an intervention for the
treatment of coronary artery disease.

The purpose of PTCA is to improve blood flow within a

coronary artery by “cracking” the atheroma.
 Indications of PTCA
patients who do not experience angina but
are at high risk for a cardiac event as
identified by non-invasive testing
patients with recurrent chest pain that is
unresponsive to medical therapy,
patients with a significant amount of
myocardium at risk but are poor surgical
candidates
patients with an acute MI (as an alternate to
thrombolysis and after thrombolysis
 PERCUTANEOUS
TRANSLUMINAL
CORONARY
ANGIOPLASTY
(A) Aballoon-tipped
catheter is passed into the
affected coronary artery
and placed across the area
of the atheroma (plaque).
(B) The balloon is then
rapidly inflated and
deflated with controlled
pressure.
(C) After the atheroma is
cracked, the catheter is
removed, and blood flow
improves.
COMPLICATIONS OF PTCA
 CORONARY
ARTERY STENT
Coronary artery stent
A stent is a woven mesh that provides
structural support to a vessel at risk of
acute closure.
The stent is placed over the angioplasty
balloon. When the balloon is inflated,
the mesh expands and presses against
the vessel wall, holding the artery open.
 INTRACORONAR
Y ARTERY
STENT.

(A) Stent closed,

before balloon
inflation.

(B) Stent open,

balloon inflated;
stent will remain
expanded after
balloon is deflated
and removed.

(C) Stent open,

balloon removed.
Valvuloplast
y
Valvuloplasty
Valvuloplasty is the dilation of
narrowed cardiac valves (usually mitral,
aortic, or pulmonary).
repair of a stenosed or regurgitant cardiac
valve by commissurotomy, annuloplasty,
leaflet repair, or chordoplasty(or a
combination of procedures)
Click to edit Master text styles
Second level
● Third level

● Fourth level

● Fifth level
 Commissurotomy
A commissurotomy is the procedure
performed to separate the fused
Balloon Valvuloplasty. beneficial for mitral valve stenosis in younger
leaflets.
patients, for aortic valve stenosis in elderly patients, and for patients
with complex medical conditions that place them at high risk for the
complications of more extensive surgical procedures.
Most commonly used for mitral and aortic valve stenosis, tricuspid and
pulmonic valve stenosis.

The procedure is performed in the cardiac catheterization

laboratory, and the patient may receive a local anesthetic.
Patients remain in the hospital 24 to 48 hours after the procedure.
 Balloon
valvuloplasty
Cross-section of
heart illustrating guide
wire and dilation
catheter placed through
an atrial transseptal
puncture and across the
mitral valve. The guide
wire is extended out
from theaortic valve into
the aorta for catheter
support.
 CORONARY
THROMBECTO
MY
Coronary thrombectomy
Coronary thrombectomy involves the
removal of a thrombus (blood clot) from the
coronary arteries. The coronary
thrombectomy catheter with the balloon
catheter are placed upstream from the
occluded area. A balloon at the distal end of
the balloon catheter is inflated, expanding
the distal end of the coronary thrombectomy
catheter.
 The balloon is then deflated, the distal tip of the
guide catheter retaining its expanded shape. The
balloon is deflated and extended beyond the
occluded portion of the artery.
CARDIAC
ABLATION
Cardiac Aablation
technique performed by
clinical electrophysiologists, cardiac
ablation is used in the treatment of
arrhythmias.
In cardiac ablation, a
form of energy renders a small
section of damaged tissue inactive.
This puts an end to arrhythmias that
originated at the problematic site
 Most often, cardiac ablation is used to
treat rapid heartbeats that begin in the
upper chambers, or atria, of the heart.
Types of SVT treated with cardiac ablation:
Ø Atrial Fibrillation
Ø Atrial Flutter
Ø AV Nodal Reentrant
Ø Tachycardia AV
Ø Reentrant Tachycardia
Ø Atrial Tachycardia
 CONGENITAL
HEART DEFECT
CORRECTION
 Congenital heart defect
Percutaneous approaches can be employed to
correction
correct atrial septal and ventricular septal
defects, closure of a patent ductus arteriosus,
and angioplasty of the great vessels.
Percutaneous valve replacement: An alternative
to open heart surgery, percutaneous valve
replacement is the replacement of a heart valve
using percutaneous methods.
NURSING
MANAGEMENT
 NURSING MANAGEMENT
Care is focused on recovery from
anesthesia and hemodynamic stability.
Vital signs are assessed every 5 to 15
minutes and as needed until the patient
recovers from anesthesia or sedation and
then assessed every 2 to 4 hours and as
needed.
Intravenous medications to increase or
decrease blood pressure and to treat
dysrhythmias or altered heart rates are
administered and their effects monitored.
Contd….
Patient assessments are conducted every 1 to
4 hours and as needed, with particular
attention to neurologic, respiratory, and
cardiovascular systems.
Nursing care continues as for most
postoperative patients, including wound care
and patient teaching regarding diet, activity,
medications, and self-care.
Contd…
Patients to prevent bacterial endocarditis
with antibiotic prophylaxis, which is
prescribed before all dental and surgical
interventions.
Patients are discharged from the
hospital in 3 to 7 days.
Home care and office or clinic nurses
reinforce all new information and self-
care instructions with the patient and
family for 4 to 8 weeks after the
procedure.
HEALTH EDUCATION
The nurse educates the patient
about
1.long-term anticoagulant therapy,
2.explaining the need for frequent
follow-up appointments and blood
laboratory studies
3.provides teaching about any
prescribed medication: the name of
the medication, dosage, ts actions,
prescribed schedule, potential side
effects, and any drug-drug or drug-
food interactions.