Tyler Locke Week 3: Cardiac Cath Lab

 This week got off to a bit of a slow start, as some car trouble kept me in Ithaca for a couple days after the cross-campus symposium. But after a new radiator I made it back to NYC Wednesday evening and got right to immersing! I went in to the Heart Failure clinic Thursday morning to meet with Dr. Horn and shadow. Unfortunately, Dr. Horn was busy with inpatient service, and the other physicians had many no-shows (heat wave perhaps?), so there weren't many patients to see. I did get to talk with her about research, and she gave me some literature to review on peripheral microvascular dysfunction, which I will be focusing on this summer.

On Thursday afternoon I went to the cath lab with Anna for the first time to shadow some procedures. We saw a couple left/right heart catheterizations to take blood pressures, oxygenations, and coronary hemodynamics for diagnosis and preoperative clearance. One of the patients had an interesting issue with their radial artery, which the doctor said he had never seen before. Because of this, they had to change their approach to the femoral artery. I went back to the cath lab on Friday morning, and got to observe a trans-catheter aortic valve replacement. The physicians spent some time reviewing the patient's CT angiogram and their approach while the patient and supplies were prepared. It was interesting to learn about how variable different patients' vascular anatomies can be, and how this affects the approach to the procedure. Once they started, I watched the live x-ray as they maneuvered the catheter through the aorta, inserted the prosthetic valve, and tested the hemodynamics using contrast dye. Overall, it was a very interesting week, and I look forward to returning to the cath lab. 

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