Invasive Catheterization Procedures Flashcards
7 cards from real CCI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Invasive Catheterization Procedures flashcards as text
During a left heart catheterization, the operator encounters significant resistance when attempting to cross the aortic valve. Which maneuver is most appropriate?
Answer: Use an Amplatz Left catheter with a looping technique through the aortic root
An Amplatz Left catheter can be manipulated to loop in the aortic root and prolapse across a stenotic aortic valve when direct crossing fails.
A patient undergoing coronary angiography develops sudden hypotension and bradycardia with contrast injection into the right coronary artery. What is the most likely cause?
Answer: Vagally mediated response from RCA contrast injection
Vagally mediated hypotension and bradycardia (Bezold-Jarisch reflex) commonly occur with contrast injection into a dominant right coronary artery.
What is the correct technique for measuring the LVEDP using a fluid-filled catheter system?
Answer: Record pressure at the Z point, just before the rapid upstroke of the LV pressure waveform
LVEDP is measured at the Z point (end-diastolic dip), just before the rapid pressure rise from LV contraction, corresponding to the end of the a wave.
Which catheter is most commonly used for selective engagement of the left coronary ostium via a femoral approach in a patient with a normal aortic root?
Answer: Judkins Left 4.0
The Judkins Left 4.0 catheter is the standard catheter for engaging the left coronary ostium from the femoral approach in a normally sized aorta.
When performing a right heart catheterization, the balloon-tipped catheter wedges prematurely in the right ventricle and shows RV waveforms. What is the next step?
Answer: Deflate the balloon and withdraw the catheter to the RA, then re-inflate and re-advance
When premature wedging occurs in the RV, the catheter should be pulled back to the RA with the balloon deflated, then re-inflated and re-floated to allow flow-directed advancement.
A Gorlin formula calculation is performed. The calculated mitral valve area is 0.8 cm². This finding is consistent with which severity of mitral stenosis?
Answer: Severe mitral stenosis (MVA < 1.0 cm²)
An MVA < 1.0 cm² by Gorlin formula calculation indicates severe mitral stenosis.
During coronary angiography, a patient develops ventricular fibrillation. What is the immediate first-line treatment?
Answer: Immediate unsynchronized defibrillation at 200 J (biphasic)
Ventricular fibrillation during catheterization requires immediate unsynchronized defibrillation as the definitive treatment to restore perfusing rhythm.