الفهرس 
Cardiac Catheterization laboratory StandardsOnly 14 pages are availabe for public view
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Abstract
Over the last half century, cardiac catheterization laboratories have evolved from highly specialized research laboratories into heavily used procedure rooms in which an extensive array of diagnostic tests and therapeutic interventional procedures are performed on millions of patients yearly.
The Pediatric cardiac catheterization laboratory (PCCL) should function as one of the critical elements within a pediatric cardiovascular center. The goals of the PCCL within a center should be to provide the diagnostic information needed to support medical, interventional, hybrid, and surgical treatments, as well as to provide the full range of interventional and hybrid treatments needed to achieve high-quality outcomes in pediatric patients with congenital and acquired heart diseases.
Diagnostic catheterizations in children are designed to evaluate structurally abnormal heart. Catheterizations usually include right and left heart catheterization, quantification of cardiac index, multichamber oximetry assessments, calculations of left-to-right and right-to-left shunts, and pulmonary and systemic vascular resistance.
Interventional procedures are the primary or a secondary objective in up to three fourths of all catheterizations performed in the PCCL. A substantial number of unique interventional procedures are performed. Most of the individual procedures are performed in relatively small numbers. These procedures include atrial septostomy, valvuloplasty, angioplasty, stent implantation in large vessels, vascular closure (patent ductus arteriosus, other anomalous vessels, and fistulae), device closure of atrial communications and ventricular septal defects, transcatheter valve implantation, endomyocardial biopsy, foreign-body retrieval, pericardiocentesis, and a range of electrophysiological procedures.
The choice of technique or agents should be based on the child’s functional status, the underlying heart disease, the type of procedure (with consideration of the risk for hemodynamic instability and complications), and the familiarity of the anesthesiologist with a specific technique.
In the evolving modern day pediatric cardiac catheterization laboratory, significant improvements have occurred, but still complications cannot be avoided. So the anesthesiologist together with catheterization team needs to be familiar with all types of emergent adverse events and their specific management protocols to maintain a high level of patient care with minimal complications.
The anesthetist has a decisive role in resuscitation and treatment when critical incidents occur even if they have a cardiological cause. Clear situational awareness and the skills and experience to recognize and treat complications are essential.
Lastly dealing with pediatric patients with congenital heart disease (CHD) is a unique challenge for the anesthesiologist due to a wide range of anatomical lesions and the need for in-depth understanding of each patient’s physiological abnormalities.