The content targets specialists and those interested in radiological and health sciences It gives an idea and a general impression of the radiological laboratory for cardiac catheterization.

2. Content:
• Definition of Cath lab and some required procedures.
• Cath lab Designer
• Radiation protection in the Cath lab and main radiological requirements.
• Types of contrast are used and main Cath lab staff
• Coronary arteries anatomy
• Standard Radiographic positioning in the cardiac procedures
• Some pictures of the radiological equipment of the Cath lab
• Additional imaging procedures
• References

3. Definition of catheterization laboratory:
A catheterization laboratory, is branch of Interventional Radiology.
Commonly referred to as a Cath Lab, is an examination room in a hospital or clinic
with diagnostic radiology imaging equipment used to visualize the arteries of the
heart and the chambers of the heart and treat any stenosis or abnormality found.
Some catheterization laboratory procedures :
Procedures including :
• Angiogram
• Angioplasty
• Ablation
• Heart Devices placement as :
pacemakers / Implantable cardioverter defibrillator ICDs.

4. Catheterization Laboratory Designer:
The cardiac catheterization laboratory must
be under complete sterilization with control
over entry and exit from the laboratory.
Therefore, a special design has been made
for the laboratory that Include:
• Reception and nursing station.
• Patient preparation area.
• Control room.
• Equipment room.
• Procedures room.
• Archive room (PACS)

5. Main radiological requirements:
Single or Dual C-arm X-ray tube voltage
at 50 to 140 kilovolts (kV).
Moving table.
Moving monitor screen.
Automatic injection device.
Shielding Lead Apron and Glasses
partitions.

6. Radiation protection in Cath lab:
The catheterization laboratory must be compatible with radiation protection.
The most important of which are :
Full shielding of the procedure room.
Shielding and provision of badges for the medical staff.
The main x-ray tube is at the bottom.
Application of the ALARA Principle (As Low As Reasonably Achievable).

7. Main catheterization laboratory staff:
• Cardiologist.
• Radiology Technologist.
• Nurses.
Types of contrast used in Cath lab:
Two types of contrast media available in the labs, they are :
• Omnipaque 300 (Iohexol)
• Visipaque 320 (Iodixanol).

8. Coronary Arteries Anatomy
Posterior View
Anterior View

9. Standard Radiographic positioning in the cardiac procedures:
Right Coronary Angiogram
(RCA) Standard Positions :
• Left Anterior Oblique (LAO(
• Left Anterior Oblique Cranial (LAOC)
• Right Anterior Oblique )RAO)

11. Left Coronary Angiogram
(LCA) Standard Positions :
• AP caudal
• AP cranial
• LAO caudal (Spider)
• LAO cranial
• RAO caudal
• RAO cranial
Standard Radiographic positioning in the cardiac procedures:

15. • Control Panel
For a radiological device for the catheterization laboratory, issued by Siemens
(Artis zee Model).
Some pictures of the radiological equipment of the Cath lab:

16. • Monitor Display
For a radiological device for the catheterization laboratory,
issued by Siemens (Artis zee Model)..

17. In some cases, to obtain more precise views of the blood artery walls,
may occasionally combine cardiac catheterization with :
• Intravascular Ultrasound (IVUS).
• Optical Coherence Tomography (OCT).
• Fractional Flow Reserve (FFR).
• Instantaneous wave-free ratio (IFR).
Only specialist medical facilities and research facilities use these imaging. techniques.
Additional imaging procedures:
(IVUS) (FFR) (IFR)
(OCT)

18. References
• Catheterization laboratory team at Prince Muhammad bin Nasser Hospital in Jizan of Saudi Arabia.
• Interpretation of Coronary Angiogram Coronary Angiogram Jae-Hwan Lee-Cardiovascular Center ,
chungnam National University Hospital in Korea .
Online References:
• https://en.wikipedia.org/wiki/Catheterization_laboratory
• https://www.cdc.gov/nceh/radiation/alara.html
• https://nagase.com.ph/news_announcements/badge-for-x-ray-radiation-ph/
• https://www.medimaging.net/radiography/articles/294787493/filtration-system-optimizes-fluoroscopy-
x-ray-beam.html

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• Twetter:
• @AbdualrahmanH10
• @Nehad_shu