History of the Cath Lab

Flashcards covering key milestones, historical figures, equipment developments, roles, and certifications in the Invasive Cardiovascular Laboratory (ICVL).

Metal pipes (~5,000 years ago)

Used by Egyptians to relieve bladder obstructions.

Stephen Hales (1711)

Used catheters in 1711 to measure blood pressure in cardiac chambers of live animals.

Werner Forssman (1929)

Inserted a catheter through an arm vein into the right atrium in 1929 and documented it with X-ray.

Catheter usage in 1941

In 1941, catheters were used to measure cardiac output.

Dr. Zimmerman (1949)

Developed the retrograde technique in 1949 to measure left ventricular pressures.

Dr. Seldinger (1953)

Developed the percutaneous femoral artery technique in 1953.

Dr. F. Mason Sones, Jr. (1959)

Performed the first selective coronary angiogram in 1959.

Vae Lucile Van Derwyst (1959)

Developed a new area of nursing practice and education in 1959.

Transseptal catheterization

Catheterization technique developed by Ross and Cope, further developed by Ross and Brockenbrough, and later refined by Mullins.

Dr. Judkins (1967)

Developed curved catheters in 1967 by using stylets to form curves in straight catheters.

Swan and Ganz (1970)

Introduced a flow-directed, balloon-tipped catheter in 1970 for right-heart pressures and thermodilution cardiac output.

Dotter and Judkins (1964)

Used dilators in 1964 to open diseased vessels.

Andreas Gruentzig (1977)

Performed the first PTCA in 1977 in Zürich, Switzerland.

PTCA

Percutaneous transluminal coronary angioplasty.

Over-the-wire balloons (1982)

Used for angioplasty in 1982 with a restenosis rate of about 40%.

Stents (1990s)

Lowered restenosis in the 1990s, though in-stent restenosis became an issue.

Cypher stent

The first drug-eluting stent, available in 2002, which lowered in-stent restenosis rates.

TAVR (2002)

Transcatheter aortic valve replacement, first performed/introduced in 2002.

Primary cath lab support roles

Monitor, circulator, and scrub person.

Support staff specialization

A tendency among cath lab support staff toward specialization, such as electrophysiology.

Modern cath lab procedures

Cardiac procedures and endovascular procedures throughout the cardiovascular system.

Modern cath lab focus

Staff training and management in modern cardiac catheterization laboratories.

Core of all cath lab work

Patient welfare.

ICVL

Invasive Cardiovascular Laboratory.

Modern ICVL team structure

A multidisciplinary team.

ICVL team members

Radiology technologists, cardiovascular technologists, nurses, respiratory therapists, operating room scrub techs, physician assistants, and non-credentialed cardiovascular technologists.

CCI

Cardiovascular Credentialing International.

CCI offerings

Offers registry exams for professionals with nursing or allied health degrees working in the ICVL.

RCIS

Registered Cardiovascular Invasive Specialist.

RCIS target audience

Staff working primarily in the catheterization laboratory.

RCES

Registered Cardiovascular Electrophysiology Specialist.

RCES target audience

Specific to the electrophysiology team.

International Board of Heart Rhythm Examiners

Offers advanced certifications for physicians and non-physician electrophysiology team members.

First PTCA location

Zürich, Switzerland (performed by Andreas Gruentzig in 1977).

Progression of cath lab development

Early catheter use → cardiac measurement → coronary angiography → catheter-based intervention → specialized multidisciplinary teams.