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Method for coronary angiography in morbidly obese patients
William G Kussmaul1, Bruce Bowers, Ismael Dairywala
1Cardiac Catheterization Laboratory, Hahnemann University Hospital, Philadelphia, Pennsylvania, USA. w.kussmaul@verizon.net
Summary
Cardiac catheterization is challenging in morbidly obese patients. A modified technique, supporting most body weight on a separate stretcher, enables successful coronary angiography and stenting with limited angulation views.
Area of Science:
- Cardiology
- Medical Engineering
- Obesity Medicine
Background:
- Morbidly obese patients present unique challenges for cardiac catheterization.
- Limitations include vascular access, radiographic penetration, and equipment constraints.
- Standard procedures may be hindered by patient weight and table mechanics.
Purpose of the Study:
- To describe an adapted technique for cardiac catheterization in morbidly obese individuals.
- To assess the feasibility and safety of this modified approach.
- To overcome physical limitations of standard catheterization tables for this patient population.
Main Methods:
- A novel method was employed where the patient's weight is primarily supported by a stretcher.
- Only the thorax is positioned on the cardiac catheterization table under the image intensifier.
- This technique facilitates access for coronary angiography and intervention.
Main Results:
- The adapted method was successfully used in six patients (five diagnostic, one stent procedure).
- No complications were reported during or after the procedures.
- The technique allowed for successful coronary angiography and intervention.
Conclusions:
- This modified cardiac catheterization technique is a viable option for morbidly obese patients.
- It effectively addresses the physical limitations posed by patient weight.
- Further research may be needed to explore optimal angulation capabilities with this method.