SFVA Cath Lab
The Cardiac Catheterization Laboratory at the San Francisco VA Medical Center performs over 1000 procedures annually, running the spectrum from simple diagnostic coronary angiography to complex structural intervention.
The Cardiac Catheterization Laboratory is equipped with the latest technology and offers a full spectrum of services. The current physical plant includes two single-plane Siemens Q Zen rooms that were updated in 2018. The catheterization suite also includes a hybrid operating room that is used for a range of minimally invasive structural heart disease interventions, including transcatheter aortic valve replacement, vascular procedures, rhythm device implants and percutaneous edge-to-edge mitral valve repair using the Mitra-Clip system.
Technology including intracardiac and intravascular imaging, 3-D echocardiography, and rotational angiography is used to further improve the safety and success rates for complex procedures. The majority of coronary procedures are currently performed from the radial approach, including distal radial where appropriate.
The SFVA Cardiac Catheterization Laboratory has a long history of active involvement in clinical research, and at any given time is actively enrolling in clinical trials. Currently-enrolling trials include the ECLIPSE trial of orbital atherectomy in heavily-calcified coronary disease, and the OPTIMIZE trial of the Svelte drug-eluting coronary stent.
Diagnostic procedures conducted in the catheterization laboratory include:
- Diagnostic coronary angiography
- Constriction and restriction studies
- Coronary, renal, peripheral and other forms of angiography
- Coronary physiology assessment with
- Endomyocardial biopsy
- Evaluation of complex valvular disease
- Intracardiac and intravascular ultrasound
- Left and right heart hemodynamic assessment
Interventional procedures performed in the catheterization laboratory include:
- Coronary angioplasty and stents to treat coronary artery disease
- Plaque removal with rotational and elliptical atherectomy
- Angioplasty and stenting for peripheral artery disease (PAD) affecting the legs or kidneys
- Balloon dilatation and stent placement to treat coarctation of the aorta
- Balloon valvuloplasty and transcatheter aortic valve replacement to treat aortic valve stenosis and balloon valvuloplasty to treat mitral valve stenosis
- Closure of paravalvular leaks associated with prosthetic heart valves.
- Nonsurgical closure of ostium secundum atrial septal defect (ASD) or patent foramen ovale
- Percutaneous edge-to-edge mitral valve repair, a minimally invasive procedure to treat mitral valve disease
- Pulmonary vein stenting to treat veins blocked after an ablation procedure
- Alcohol septal ablation to treat hypertrophic cardiomyopathy
- Use of intra-aortic balloon counterpulsation and percutaneous left ventricular assist device (Impella).