CCI Invasive Catheterization Procedures 3

Question 1

What is the significance of a 'damping' waveform observed when a catheter is positioned in the coronary ostium?

Accepted Answer

It suggests catheter tip occlusion of the ostium, risking ischemia or dissection

Answer

A damped waveform indicates the catheter tip is obstructing coronary flow, which can cause ischemia, ventricular fibrillation, or ostial dissection if not corrected immediately.

Question 2

Which of the following correctly describes the transpulmonary gradient (TPG)?

Accepted Answer

Mean PAP minus mean PCWP

Answer

The transpulmonary gradient equals mean pulmonary artery pressure minus mean pulmonary capillary wedge pressure, reflecting resistance across the pulmonary vascular bed.

Question 3

A patient undergoing diagnostic catheterization has an oxygen saturation step-up of 8% between the right atrium and right ventricle. What diagnosis should be suspected?

Accepted Answer

Ventricular septal defect (VSD)

Answer

An oxygen saturation step-up at the RV level (≥5%) indicates a left-to-right shunt at the ventricular level, consistent with a VSD.

Question 4

What is the purpose of using a long sheath during radial artery access for coronary angiography?

Accepted Answer

To reduce radial artery spasm and facilitate catheter exchanges

Answer

A long radial sheath reduces friction during catheter exchanges and minimizes radial artery spasm caused by repeated catheter manipulation.

Question 5

Which complication is uniquely associated with the transradial approach compared to the transfemoral approach?

Accepted Answer

Radial artery occlusion

Answer

Radial artery occlusion is a complication specific to transradial access, occurring in approximately 1–5% of cases, though it is usually asymptomatic due to dual hand circulation.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Invasive Catheterization Procedures 3