Brief History of Cardiac Catheterisation Gemma C. Ryder Intra-cardiac catheter 4 Major Events in CC History Early catheterisation 1

Brief History of Cardiac Catheterisation Gemma C. Ryder Intra-cardiac catheter 4 Major Events in CC History Early catheterisation 1 www.phwiki.com

Brief History of Cardiac Catheterisation Gemma C. Ryder Intra-cardiac catheter 4 Major Events in CC History Early catheterisation 1

Carden, Evan, Managing Editor has reference to this Academic Journal, PHwiki organized this Journal Brief History of Cardiac Catheterisation Gemma C. Ryder g.c.ryder@qmul.ac.uk Intra-cardiac catheter A thin tube passed to the heart via a vein or artery Used to withdraw blood Measure pressure in heart chambers or great vessels Inject contrast media For diagnosis in addition to evaluation of congenital conditions in addition to coronary artery lesions To evaluate systolic in addition to diastolic cardiac function 4 Major Events in CC History Development of techniques as long as measuring intracardiac physiologic events in animals Application of these techniques to humans Development of coronary angiography Development of catheter-based procedures

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Early catheterisation 1 In 1711, Stephen Hales conducted the first cardiac catheterisation of a horse using brass pipes, a glass tube in addition to the trachea of a goose. Early catheterisation 2 In 1844, Claude Bernard inserted a mercury thermometer into a horse carotid artery Early chemotherapy required the injection of drugs directly into the central circulation. Bleichroeder inserted catheters into dog arteries in addition to assessed the effects after leaving them in place as long as several hours. He reported no complications or clots. First catheterisation in a human In 1929, a German surgical trainee, Werner Forssmann, experimented on a human cadaver in addition to realized how easy it was to guide a urological catheter from an arm vein into the right atrium In the early 1940’s, Courn in addition to , working in New York,began utilizing right heart catheterisation on a regular basis in the undertaking of a comprehensive investigation of cardiac function in both normal in addition to diseased patients

Development of catheterisation 1953 Seldinger developed a percutaneous approach as long as the introduction of catheters as long as both right in addition to left heart catheterisation In the 1950’s, diagnostic catheterisation became established as the best method as long as confirmation of clinical findings prior to cardiac surgery as long as valvular or congenital heart disease. Vascular Access Prior to Seldinger – vascular access via cutdown Complications Haemorrhage Infection Acute thrombosis Distal embolisation Cut Down

Seldinger Technique Inject local anaesthetic Locate artery Puncture with 18G needle Advance guidewire thru’ into artery Remove needle in addition to advance introducer sheath Seldinger Technique Seldinger Technique

Complications of Seldinger Technique Haemorrhage AV fistula Dissection Embolism/Thrombosis Closure Manual compression Closure devices Closure Device Closure Device 2

Complications of Catheterisation Thrombosis Extrinsic – catheter material Heparin PTFE, coatings Intrinsic – endothelial damage Catheter design Coronary Angiography 1958 Accidental discovery by Sones Involves injecting contrast agent into the coronary arteries Cine-angiography X-ray images taken in rapid succession to capture the dye’s progression Coronary Angiography

Coronary Angiography Angiography Video 1 Angiography Video 2

Coronary Angiography Catheter-based procedures Valvuloplasty – to open stenotic valves Pacemaker implantation Angioplasty 1974 peripheral/1977 coronary Atherectomy Lasers Stents Catheter based interventions are now very common 1997 — over one million angioplasties per as long as med worldwide, making angioplasty the most common medical intervention in the world 2001 — almost two million angioplasties were per as long as med worldwide, with an estimated increase of 8% annually 2002 — the 25th anniversary of the first angioplasty per as long as med in an awake patient

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Carden, Evan Managing Editor

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