Understanding “ Damping and Ventricularization ” in cath lab.

“Never take your eyes off the monitor and the pressure curve”  It is one of the basic instructions given to the fellows & technicians as they start engaging the coronary artery and Intubating the coronary ostium in their early cath lab postings. There are two commonly heard noise bites in the cath lab for the beginner. 1. Damping 2.Ventricularization. Damping It is the deformation of the normal arterial pressure curve, with a  blunting of both systolic and diastolic pressure that drops compared to aortic pressure. Extreme damping can mimic a straight line with few wavy undulations. It means the forward flow is impeded as the catheter might be blocking the coronary flow at least partially, if not completely. Immediate pull back and adjustment of catheter is required to prevent adverse events that includes cardiac arrest. (Of course, catheter kinks, blocks, and air in a circuit are to be ruled out first)   Mechanism of damping The catheter tip is too large for the ostium.(Technical) A left main or RCA ostial lesion*(Most significant clinically) The coronary artery wall is thin and goes for spasm Catheter diameter is too small and glides into the coronary artery (The catheter tip  hitches against the lateral wall of the coronary artery often over a plaque, a silently staged perfect setting for a dissection ) Unique features in RCA damping In RCA,  damping could simply mean it has engaged conus branch. Damping is more common in RCA and it tends to ge...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized coronary artery damping and ventricularization Source Type: blogs