Vanderbilt Cardiac Cath Core Curriculum

Reference

(Grossman – G

First Year CathSap – CS)

Understand radiologic imaging
  • Design/operation of X-ray cineradiographic units
  • Digital imaging and storage
  • Radiation physics and safety
  • Factors influencing imaging quality
  • Radiation quality assurance
/ G 2
CS 5.1, 5.2
Indications for cardiac cath / G1
Access femoral artery, vein, radial artery
  • Needles
  • Sheaths
  • Guidewires
/ G 4
CS 4.2, 4.3
Coronary and bypass graft angiography
  • Types of contrast media (hemodynamics, complications, cost)
  • Types of catheters
  • Standard views
  • Normal anatomy
  • Quantitate stenosis
/ G 11
CS 4.3, 4.6, 4.8, 4.9
Left Ventriculography and Left Heart Catheterization
  • Volume injected, PSI
  • Size, wall motion, EF, estimate MR
  • LVEDP
/ G 12
CS 4.7
Manifold use / Obtain practice manifold
Hemostasis of femoral access
  • Manual
  • Femstop
  • Closure device use (angioseal, starclose, perclose, etc.)
  • Chitoseal, Quikclot, Cyvek patches
/ CS 14.2
Hemostasis of radial access
  • Manual
  • TR Band

Management of periprocedural complications
  • Renal dysfunction
  • Retroperitoneal bleeding
  • Vascular complications
  • CVA
/ CS 4.1, 14.1
Right Heart Cath and Cardiovascular hemodynamics
  • WITT data manipulation
  • Recognize and measure basic pressures and pressure wave forms (A, V, mean)
  • Measurement of cardiac output (Fick and thermodilution)
  • Measurement and interpretation of gradients
  • Calculation of mitral and aortic valve areas: Gorlin formula
  • Measurement and calculation of shunts (left to right and bidirectional)
  • Understanding hemodynamics in common congenital heart diseases including ASD, VSD, PDA
  • Tamponade vs. Constriction vs. Restriction
  • Pulm HTN w/ vasodilator and fluid challenge
  • Hypertrophic obstructive cardiomyopathy
/ G 7-10
CS 4.4, 4.5
Understand indications and adverse reactions for drugs commonly used for invasive procedures
  • UFH/LMWH heparin
  • Direct thrombin inhibitors (e.g. bivalirudin)
  • Antiplatelets (ASA, Theinopyridines, G IIb/IIIa inhibitors)
  • Thrombolytics
  • Vasopressors/vasodilators
  • Management and prevention of contrast allergy
/ G 3
CS 6

Second/Third Year

Panning, shot set up, gantry manipulation
Anomalous coronary anatomy
Miscellaneous cath lab procedures
  • Temporary pacing wire
  • IABP
  • Endomyocardial biopsy
  • Pericardiocentesis
/ G 14, 20, 21
IVUS/ICE / CS 5.4
Coronary Physiology
  • Fractional flow reserve (Pressure wire)
  • Coronary flow reserve (Doppler wire)
/ G 18
CS 5.5
Aortography and Peripheral Angiography / G 14
CS 12
Understanding of catheter based interventions
  • Coronary angioplasty/stenting
  • ETOH Septal ablation for HOCM
  • Peripheral vascular angioplasty
  • Closure of ASD and patent foramen ovale
  • Aortic/mitral valvuloplasty
/ G 22-27

Multi-imaging modality Cath Conference Wednesday 7AM-8AM

Interventional Conference Friday 7AM-8AM

Interventional Attending Rounds Thursday AM ( Varied Attendings – Core Lectures)

Cath COCATS requirements:

Total months Number Performed

Level 1 4 100

Level 2 8 300

Level 3 Interventional Fellowship

Recommended References:

1.Baim, Donald, editor. Grossman's cardiac catheterization, angiography, and intervention. 2005. (Access via Eskind Library website)

2.CathSap. Access at via Eskind Library website.

3.