cath lab display screens supplier

Cardiac Cath Lab display monitors such as the Modalixx offer a multi-modality approach which sanctions the exhibition of a wider range of imagery and promotes efficient work flow. The constant advances in medical imaging technology called for upgraded systems from old CRT monitors, these auto-sync devices are produced to combat this issue. Compatible with a multitude of well-known manufacturers such as GE, Siemens, Toshiba, Shimadzu, Philips and other modalities, Ampronix is constantly working to offer imaging solutions for all display and peripheral needs in the medical field.

Frustrated with outdated display equipment preventing you from providing the highest quality of care in your interventional lab? The Carrot C-View Large Display System consolidates a bank of separate video sources into a 4K 58 inch display. Provide the highest quality care to your patients with the Carrot C-View.

The Quantum Workstation from Spectrum Medical eliminates these potentially un-safe distractions with the launch of the world’s first Central Display System designed specifically for use with Perfusion or ECMO.

"By combining a user configurable central display and Spectrum Medical’s ‘Real Time Device Connectivity Software" clinician response time to critical clinical data is improved, as is the quality of patient care.” (reference NYP article).

Setting up a cath lab with all the right options for your specialty, your workflow, and your physicians" preferences comes with a lot of questions. Among those we"re asked most often: How many monitors come with a cath lab system?

The answer to that question isn"t 100% cut-and-dry, but we can help you know what to expect as you begin shopping. Keep reading to learn more about monitor options for your next cath lab system.

Typically, cath labs come with just 2 monitors included on the monitor suspension arm: a live monitor, and a reference monitor. Seems like an easy enough answer, right?

The extra positions on the monitor suspension are for, you guessed it, extra monitors! Okay, that’s a bit of an over-simplification, so let us explain. In the cath lab, more than any other modality, peripheral systems are used to help treat the patient. Depending on what these systems are and how many you have, it may be preferable to add one, two, or even six more monitors onto your suspension.

Most cath labs use a hemodynamic monitoring system such as a GE MacLabduring studies. There is often a monitor on the suspension that displays the patient"s physio data in real time so the staff has immediate feedback from the MacLab.

If you’re in a lab that performs 3D studies, there is a good chance the cath lab itself is unable to reconstruct the raw data acquired during a study. In this case, a reconstruction workstation such as a GE Advantage Windows Workstation (AWW) is needed to reconstruct the images. When a reconstruction workstation is in use, one of the monitor slots on the suspension can be dedicated to displaying reconstructed image data.

When a site orders a new cath lab from the manufacturer the number of spaces available on the monitor suspension can be selected. If you plan to purchase your lab on the secondary market, be sure to talk to your provider early on about how many monitor spaces you"ll need so they can accommodate. For single-plane labs, suspension systems are available with two to six monitor spaces. Suspensions for up to eight monitors are available for biplane systems.

If you have additional questions about monitors or monitor suspensions, are in need of a cath lab, or need some peripheral equipment to help fill out your monitor suspension, call or email us today

If you’re involved with managing a Cath Lab have you had your physicians ask to upgrade to a newer digital interventional x-ray system or add high-definition digital large flat screen monitor displays?  When planning a remodeling project or lab expansion it is important to have the latest in imaging technology.  In order to keep cardiologists happy, or recruit new physicians, hospitals need to be competitive in the local market and provide the newest and highest-quality digital imaging.

But the process to upgrade an x-ray system or add a new lab suite can take time.  Starting with budgeting, waiting for funding, approvals, PO’s, and construction schedules it can take anywhere from a few months to a few years to complete.

We’re aware of these challenges and for over 30 years Modular Devices Inc. has offered solutions to lab upgrade and expansions with our interim Mobile Cath Lab and Modular Cath Labs.  Our interim Cath and Vascular Lab systems can be quickly and easily brought in and parked at a hospital to provide support on either a short (month-to-month) or long-term basis.  Our labs are equipped with the latest digital flat panel detector cardiac/interventional imaging systems, offering an effective way to provide your physicians with newer x-ray imaging technology in the interim while plans are being made to upgrade the in-house lab to new equipment.

In order to properly maintain our fleet of 26 interim labs we’re continually updating the x-ray systems and making other improvements to keep them up to date with the latest technology.

Always listening to our customer’s feedback and reviews we’re very excited to announce the most recent update to our interim lab fleet – large flat screen monitor displays.  These high-definition large flat screen monitors measure between 50″-58″ and replace the typical display setup mobile Cath Labs which includes a ceiling-mounted boom with 3 LCD displays (live, reference and hemodynamic monitoring).

In the past we could add additional monitors to the boom for clients who utilize an IVUS system or for 3D EP imaging, for example,  but with the large flat screen monitor displays the inputs can be be displayed and rearranged on different sections of the large flat screen display.

This new product roll-out is the perfect solution for long or indefinite term Modular Cath Lab projects where physicians require a large screen monitor in an interim Cath Lab now while they wait for the new lab construction project to be completed down the road.

If you’re interested in learning more about our Mobile and Modular Cath, Vascular Lab solutions can help with a lab renovation or expansion – give us a call at 800-456-3369 or click here to Contact Us.

A catheterization laboratory, commonly referred to as cath lab, is a vital piece of diagnostic equipment for hospitals and healthcare facilities. A cath lab is an exam room equipped with diagnostic imaging technology to provide physicians with visual access to chambers and arteries of the heart. In these spaces, a team of physicians perform life-saving procedures, including coronary angiography, catheterization, balloon angioplasty, percutaneous coronary intervention, congenital heart defect closure, stenotic heart valves and pacemaker implantations. A typical cath lab consists of a C-arm, image intensifier, X-ray tubes, and several displays.

Cath lab operations depend completely upon medical displays, which allow physicians to visualize a patient internally and perform the necessary procedure. The digital age has ushered in improved imaging technologies, which emit less radiation and also provide greater visual clarity to physicians. The adoption of CRT monitors in the cath lab brought about significant changes in their operations. CRT displays were followed by the advent of LCD screens. Most hospitals and healthcare facilities upgraded to LCD screens as they are slimmer, portable and offer higher resolution images. Currently, cath labs are witnessing yet another transition in medical monitors, as professionals are upgrading from LED displays to ultra-high definition 4K technology. Instead of using four to six displays, hospitals and healthcare facilities are upgrading to one large UHD 4K display. However, healthcare providers need to consider several variables before deciding upon the kind of upgrades they can make. Additionally, the switch from the LED model to the 4K display system introduces issues related to maintenance and safety.

Ampronix (Irvine, CA, USA), an authorized master distributor of the medical industry"s top brands and a manufacturer of innovative technology, has been repairing and selling 4K monitors of different sizes for cath labs and hybrid ORs to hospitals for years. Ampronix undertakes sale, service and repair of cath lab monitors manufactured by several well-known companies such as Philips, GE, Siemens, Shimadzu, Toshiba, Hitachi, Eizo, Barco, Chilin and Optik View. Ampronix offers tailored, one-stop solutions at a faster and more cost effective rate than other manufacturers. The company has most models in stock that are available at half the OEM price.

The company’s services also include preventive maintenance, replacement of LCD, backlights, reflectors and power supplies. Any display failure amounts to an entire cath lab rendered obsolete until a replacement or repair solution is provided. However, the turnaround time for either of those protocols can be several weeks. Given the importance of the cath lab for healthcare providers, Ampronix ensures that they have zero downtime in the event of their monitors requiring service or replacement. The company has a readily available response team of ESD- and ASQ-certified technicians to assist and answer questions for urgent repairs. Nation-wide requests received by 2pm PST receive same-day or next-day delivery. Ampronix also has capable and competent customer service representatives for addressing all medical technology questions and concerns. With its extensive product knowledge, outstanding service, and state-of-the-art repair facility, Ampronix continues to meet the needs of the medical community and move forward with its goal to facilitate optimized patient care and improved physician workflow.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

Choose from a variety of configurations of the Interventional Hemodynamic System. Each system comes with a patient monitoring device mounted at the table side. Single and dual configurations of the workstation are available. With the dual display configuration in the control room you can always view patient monitoring, hemodynamic analyses and reports on a full screen.

Choose from a variety of configurations of the Interventional Hemodynamic System. Each system comes with a patient monitoring device mounted at the table side. Single and dual configurations of the workstation are available. With the dual display configuration in the control room you can always view patient monitoring, hemodynamic analyses and reports on a full screen.

Choose from a variety of configurations of the Interventional Hemodynamic System. Each system comes with a patient monitoring device mounted at the table side. Single and dual configurations of the workstation are available. With the dual display configuration in the control room you can always view patient monitoring, hemodynamic analyses and reports on a full screen.

Choose from a variety of configurations of the Interventional Hemodynamic System. Each system comes with a patient monitoring device mounted at the table side. Single and dual configurations of the workstation are available. With the dual display configuration in the control room you can always view patient monitoring, hemodynamic analyses and reports on a full screen.

Each system comes with a IntelliVue X3 a compact patient monitor. When mounted at the table in the cathlab, you have unrestricted access to your patient from nearly any position, without restricting table movement. It’s small enough to hold in your hands and can be easily mounted where you need it most.

Each system comes with a IntelliVue X3 a compact patient monitor. When mounted at the table in the cathlab, you have unrestricted access to your patient from nearly any position, without restricting table movement. It’s small enough to hold in your hands and can be easily mounted where you need it most.

Each system comes with a IntelliVue X3 a compact patient monitor. When mounted at the table in the cathlab, you have unrestricted access to your patient from nearly any position, without restricting table movement. It’s small enough to hold in your hands and can be easily mounted where you need it most.

Each system comes with a IntelliVue X3 a compact patient monitor. When mounted at the table in the cathlab, you have unrestricted access to your patient from nearly any position, without restricting table movement. It’s small enough to hold in your hands and can be easily mounted where you need it most.

The fully integrated functional measurement option allows you to perform and analyze instant wave-free Ratio (iFR) Spot and Scout pullback measurement in both the exam and control room. This is your gateway to bring the latest hemodynamic monitoring and physiological techniques into the interventional lab.

The fully integrated functional measurement option allows you to perform and analyze instant wave-free Ratio (iFR) Spot and Scout pullback measurement in both the exam and control room. This is your gateway to bring the latest hemodynamic monitoring and physiological techniques into the interventional lab.

The fully integrated functional measurement option allows you to perform and analyze instant wave-free Ratio (iFR) Spot and Scout pullback measurement in both the exam and control room. This is your gateway to bring the latest hemodynamic monitoring and physiological techniques into the interventional lab.

The fully integrated functional measurement option allows you to perform and analyze instant wave-free Ratio (iFR) Spot and Scout pullback measurement in both the exam and control room. This is your gateway to bring the latest hemodynamic monitoring and physiological techniques into the interventional lab.

By connecting the IntelliVue X3 in the cath lab with the Philips Hemo system, you can continuously monitor a patient. There is no need to change cables, minimizing disruption and giving you more time to focus on your patient.

By connecting the IntelliVue X3 in the cath lab with the Philips Hemo system, you can continuously monitor a patient. There is no need to change cables, minimizing disruption and giving you more time to focus on your patient.

By connecting the IntelliVue X3 in the cath lab with the Philips Hemo system, you can continuously monitor a patient. There is no need to change cables, minimizing disruption and giving you more time to focus on your patient.

By connecting the IntelliVue X3 in the cath lab with the Philips Hemo system, you can continuously monitor a patient. There is no need to change cables, minimizing disruption and giving you more time to focus on your patient.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

In the control room, clinical staff can monitor all patient vital signs, analyze physiological parameters and easily display calculation results in the exam room. Results are displayed as a numerical value and a gradient image. Displaying numerical and graphical results helps clinical staff stay focused on the tasks at hand without the need to leave the sterile area.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The new user interface provides on-screen guidance to help team members smoothly proceed through procedures and work efficiently with each other. The workstation"s interactive heart diagram aids team members in the control room in quickly performing pullbacks and changing the pressure labels. These features promote ease of use by all staff members with minimal training.

The OPTIS™ Imaging System with a compatible Dragonfly™ Imaging Catheter is intended for the imaging of coronary arteries and is indicated in patients who are candidates for transluminal interventional procedures. The compatible Dragonfly™ Imaging Catheters are intended for use in vessels 2.0 to 3.5 mm in diameter. The compatible Dragonfly™ Imaging Catheters are not intended for use in the left main coronary artery or in a target vessel which has undergone a previous bypass procedure.

The OPTIS™ Imaging System is intended for use in the catheterization and related cardiovascular specialty laboratories and will further compute and display various physiological parameters based on the output from one or more electrodes, transducers, or measuring devices. The physician may use the acquired physiological parameters, along with knowledge of patient history, medical expertise and clinical judgment to determine if therapeutic intervention is indicated.

Contraindications: The OPTIS™ Integrated System and Mobile System with Software are contraindicated where introduction of any catheter would constitute a threat to patient safety. Contraindications include:

Observe all advancement and movement of the Dragonfly™ Imaging Catheter under fluoroscopy. Always advance and withdraw the catheter slowly. Failure to observe device movement fluoroscopically may result in vessel injury or device damage.

If resistance is encountered during advancement or withdrawal of the Dragonfly™ Imaging Catheter, stop manipulation and evaluate under fluoroscopy. If the cause of resistance cannot be determined or mitigated, carefully remove the catheter and guidewire together.

The Dragonfly™ Imaging Catheter should never be forced into lumens that are narrower than the catheter body or forced through a tight or heavily calcified lesion.

When advancing or retracting a catheter with a monorail tip through a stented vessel, the catheter may engage the stent between the junction of the Dragonfly™ Imaging Catheter and guidewire, resulting in entrapment of catheter/guidewire, catheter tip separation, and/or stent dislocation.

The Dragonfly™ Imaging Catheter is sterilized by ethylene oxide and is intended for one time use only. Non-pyrogenic. Do not use if the package is opened or damaged.

After use, the Dragonfly™ Imaging Catheter may be a potential biohazard. Handle and dispose of in accordance with accepted medical practice and applicable laws and regulations.

For diagnosis and treatment of coronary artery disease, you demand crystal clear images of the moving heart and of challenging cardiac anatomies in any angulation. To spice up the challenge, dose has to be kept to a minimum even during complex procedures. Our Artis zee systems deliver images in excellent quality and at low dose, displayed the way you like them best with CLEARchoice. A wide variety of software tools supports the toughest percutaneous coronary interventions. Find out how these and other smart solutions from Siemens can support you in your routine and advanced procedures for coronary artery diseases.

ACOM.PC software turns every standard PC into a professional cardiac review workstation. Image processing and diagnostic tools are tailored to the needs of cardiologists, internal medicine specialists, and cardiac surgeons. Connecting to the Artis system, PACS or standard network storage, ACOM.PC can be completely integrated into your department’s IT landscape and also be used as nearline storage offering high-speed access to image data. ACOM.PC can be assigned to a separate display in the examination room for the parallel processing-like review of previous studies during ongoing examinations.

Treatment options for structural heart disease (SHD) are flourishing at a fast pace with the development of new devices, hardware, and software. These technological innovations can replace surgical procedures with percutaneous interventions, often allowing treatment of previously untreatable patients. This leads to new challenges for physicians and their team – as well as for imaging in terms of workflow or multi-modality integration. Siemens’ syngoDynaCT Cardiac has revolutionized cardiac imaging, bringing intra-procedural 3D visualizations of the cardiac chambers and vessels of the beating heart into the cath lab. Based on this technology, we also offer software tools that allow fusion of other 3D imaging modalities like CT or MR for transfer of pre-procedural images used for intervention planning into your ongoing procedure. In addition, you can overlay points of interest or whole 3D structures and acquire peri-procedural 3D images for improved guidance during demanding SHD or vascular procedures. Dedicated workflow support tools facilitate procedures like transcatheter aortic valve replacement (TAVR). Find out how our solutions can support you in the dynamic and fast changing environment of SHD treatment.

Create CT-like images of the heart in your cath lab using rotational angiography – with syngo DynaCT Cardiac. The high-quality 3D images support you in analyzing the cardiac anatomy to plan and guide complex SHD procedures. Fuse 3D volumes acquired with other modalities or mark regions of interest in pre- and intra-procedural 3D images, which can be overlaid onto live 2D images. Here as well, linking the C-arm to a 3D image helps you define the optimal projection angle – without additional contrast media or fluoroscopy.

syngoiGuide Toolbox allows you to overlay points of interest from 3D volumes onto 2D live images right on the Artis display. Using the linked cursor feature, you can quickly and easily import the points of interest into the 2D live images ‒ exactly matching the findings in the cross-sectional images of a syngoDynaCT Cardiac acquisition, for example. It takes just a single click to create anatomical outlines of segmented 3D volumes, which can be especially helpful for mitral valve repair or for vascular procedures like aortic aneurysm stenting. The information that is overlaid using syngoiGuide Toolbox is automatically updated should you change the C-arm angulation, the zoom factor or move the table.

Covering everything from imaging and recording to 3D guidance and co-registration with the latest mapping and navigation systems. Smart solutions designed to set new standards of care, safety, and efficiency for your EP lab.

With the help of rotational angiography, syngo DynaCT Cardiac creates CT-like 3D images of the beating heart directly in your cath lab. There is no need for pre-procedure CT, and you get high-quality 3D volumes during the case. ECG-gated acquisition enables visualization of the coronary sinus and the ventricles for procedure planning. Special low-dose algorithms can be used to fuse 3D angio images with CT and MR.

With its convenient one-click segmentation, syngo InSpace EP allows you to quickly and effectively segment the cardiac chambers, thus reducing time-consuming manual interactions. Excellent AFib ablation planning by visualizing the individual LA morphology, improved orientation and catheter guidance during mapping and ablation and esophagus visualization for reduced risk in AFib procedures are three benefits. It allows you to view inner surfaces of segmented chamber with a clipping function and an easy point tagging function to plan the ablation path and for documentation purposes.

Enhance catheter guidance during ablation with syngo iPilot. Application provides an overlay of 3D segmentation results (from syngo DynaCT, CT or MR) onto live fluoroscopy. It allows overlaying pre- and intra-procedurally acquired 3D volumes onto live fluoroscopy or acquisition.

The dual-volume visualization for enhanced decision-making during intervention enables the differentiation between two high-contrast 3D objects that have virtually the same contrast density or allows the display of syngoDynaCT and 3D Angio in one view.

Enables previous CT, MR or PET CT images to be fused with high-contrast angio 3D or syngoDynaCT datasets. syngoInSpace 3D/3D Fusion not only displays relevant diagnostic data from other modalities in the angio suite but serves as foundation for exact overlay of 3D volumes and planning data onto live fluoroscopy during treatment (using syngoiPilot®).

Effective device guidance during interventional procedures, providing a simultaneous display of the live fluoro, roadmap or acquisition image and a matching 3D volume or planning data to facilitate guidance during complex interventions. The system updates dynamically to movements of the C-arm, table, zoom, and source-to-image distance.

A 3D functional imaging application that provides physiological information directly in the interventional lab. The software indicates the distribution and amount of blood in lesions and surrounding tissue by means of color-coded cross-sectional blood volume maps.

EVAR-3D Guidance overlays 3D information on top of live fluoroscopy and stands for optimized C-arm angulations, precise 3D overlay, and guidewire and catheter navigation.

There have been tremendous advances in 3-dimensional (3-D) technologies in the past few years, not only in various medical and surgical fields but also in our daily lives outside of work; with more and more new features in cell phones, computer design programs, and movies!!  4-dimensional (4-D) imaging captures 3-D images over time. These technologies are particularly important in cardiology, especially in interventional cardiology. The heart is a very dynamic organ, and understanding the variation in the anatomy of vessels and geometry of cardiac structures is key to ensuring successful procedures, patient’s safety and good outcomes. More recently, newer innovations in both 3-D and 4-D technologies have been developed, so I decided to shed light on some of these innovations and how they can be potential game-changers in the cath lab.

This technology was actually displayed at the Transcatheter Cardiovascular Therapeutics (TCT) 2019 meeting. It converts live transesophageal echo (TEE) imaging into real-time 3-D holographic video in the cath lab to aid structural heart procedures.  The 3-D hologram is projected on a special display screen, and the interventional cardiologist uses hand movements and a foot pedal/switch to change the image orientation without breaking the sterile field. It also allows the operator to see the tools they use in the cath lab, including catheters or devices, in real-time in a 3-D format. This technology does not even require the user to wear 3-D glasses! It was submitted for FDA regulatory review in September 2019.

In conclusion, we have seen and continue to see tremendous advances in the innovations of 3-D and 4-D imaging with important implications in our work in the cath lab. With our continued collaboration with informational technology experts, engineers, and scientists, these innovations are potentially game-changers in different fields, including coronary interventions and structural heart procedures. I look forward to seeing how this technology continues to evolve in the coming decades!!

Catheterization laboratories (cath labs) exist in a vast array of sizes and configurations. Each lab is classified by its primary function, and that function dictates the particular modalities that are found in that laboratory. Procedures involving catheters are a popular option because they are minimally invasive and generally lead to positive outcomes. Cath labs commonly found in hospitals include cardiac catheter labs (heart investigation units); neurological catheter labs; and generic catheter labs that are used for a multitude of procedures such as chemotherapy, vertebroplasties, and tumor isolation.

Regardless of function, cath labs all consist of a movable operating table, C-arm(s), four to six monitoring screens, and an operator"s station with additional monitors and controls. The operator"s station is usually isolated from the patient. The cath lab functions by taking x-ray photographs, via the C-arms, which are then stored in the hard drive of each individual room"s system and are viewed throughout the duration of the procedure. After each case, all x-ray images are saved to the hospital"s picture archiving and communication system (PACS). Although this system is extremely effective when operating properly, adverse events can occur if the mainframe of the system were to crash. As all x-ray photos are not saved until completion of the procedure, all images taken to the point of the system failure could be lost (see “Troubleshooting” below for more on the system"s memory).

A cath lab can be classified as either single plane (one C-arm) or biplane (two C-arms) depending upon its application and the intensity of the procedure the lab was designed for. Cardiac and neurological catheterization laboratories are always biplane. Cath labs designated for coronary angiography and electrophysiology are usually single plane. Biplane labs are extremely efficient since the dual C-arm technology allows two angles to be imaged simultaneously. This capability is essential for adult interventional procedures and many pediatric cases. Despite their primary designation, many catheter labs are also interchangeable across functions so that they can accommodate different procedures as necessary or during an emergency situation.

The catheterization laboratory can be divided into two sections: the procedure room and the control room. The procedure room, where the actual catheterization takes place, consists of an x-ray table, all imaging equipment, and four to six display screens positioned adjacent to the table. Heart monitoring equipment is also adjacent to the table and one display screen is reserved for vital sign monitoring. At least one display screen is designated for the reference image and the others are for transmitting the live image. The reference image is a still image saved on one of the screens that allows the doctor to consistently compare the live image against it. The reference image can be changed throughout the procedure simply by capturing a new image with the foot pedal.

The control room is separate from the procedure room. This room usually consists of a viewing monitor that allows the medical staff to observe the surgical field from several angles. This room also displays the patient"s vital signs and in some cases contains a hemodynamic monitoring system that enables staff to continuously monitor the patient"s electrocardiogram and heart pressures.

Catheterization laboratories are capable of digital image processing and usually contain variable fluoroscopy rates. Since most catheterization laboratories are able to accommodate digital image acquisition at 30 frames per second, all digital files can be stored and accessed anywhere in the entire hospital through PACS. The x-ray portion of the laboratory—the C-arm—functions by converting all x-ray signals to digital data. This is done via a binary system, which assigns a series of ones and zeros to each shade of grey and black. This binary code is then processed and interpreted by a computer and displayed on flat-panel computer monitors suspended within the laboratory and in the control room.

Regardless of the type of cath lab or the procedure being performed, clinicians rely on related technologies to successfully insert and guide the catheter. These include:Guide Wires

Catheters are often introduced into the body via guide wires to allow for tracking and steering when maneuvering a catheter to its desired destination. Guide wires enter the body through either the brachial or femoral artery. Once in place, the catheter is then inserted over the wire and threaded throughout the body. All guide wires must be stiff enough to push through a thrombus, but not so stiff that they dissect or puncture an arterial wall.Balloon Catheters

Balloon catheters are soft catheters that are used in vivo to enlarge a narrow opening in the body. Equipped with a deflated balloon at its tip, the catheter is positioned in its preferred location and then inflated via pressure throughout the duration of the procedure. Typical applications of balloon catheters are during angioplasties for the deployment of stents and tuboplasties during uterine catheterization.

While catheterization imaging has become a frequently used technology in the medical community, many more advancements are still being developed to make the system more user friendly. Currently, C-arms are being developed to function more like a robotic arm. These arms can be positioned and bent in ways the traditional C-arms, with their rigid structure, cannot. This new design will also help to eliminate collisions and provide a way to store the arm parallel to the ceiling. Finally, since cords are often misconnected and accidentally unplugged, a wireless foot pedal is being developed, along with software that is activated by voice recognition.

This integrated imaging system also features a digital subtraction option for peripheral studies. The digital subtraction function operates by recognizing an isotope of dye or contrast agent that appears in each image. It allows these subsequent x-ray photos to be overlaid to detect a difference in dye distribution or catheter placement. The image difference can then be used as the new reference image; parts of the previous image that were synonymous to the new image can be eliminated. This technique is often used for road mapping and is quite effective when viewing a moving catheter. Some systems even allow for post-image processing where contrast and brightness can be altered to obtain the best image possible. During the procedure, all pictures are stored on a local server and recorded to a compact disc. This enables the physician to obtain the most accurate information available for comprehensive assessment of the patient"s condition and subsequent treatment planning. After the procedure, physicians can choose which images will be saved to the hospital"s PACS.

In cardiac cath laboratories, analytical physiological software allows medical staff to compile all the hemodynamic data that monitors the flow of blood through the heart. The software also records pictures of the heart in sequence and presents a comprehensive report of the heart muscle throughout the surgery. The system allows for quick transport of images to the server, allowing access from physicians" offices. If patients require additional surgery or other advanced procedures, this information can be immediately transferred to other care facilities.

The final segment of technology that exists within the catheterization laboratory is the mechanical equipment. This consists of the C-arms themselves, which are suspended by ceiling cranes, and the patient table. In most permanent catheterization laboratories the C-arms are fixed within the room. However, movable C-arms can be used for less invasive procedures that require imaging. These C-arms are on wheels and can easily be transported from laboratory to laboratory as necessary. All C-arms that are mechanically constrained to the ceiling are equipped with sensors to detect if the arm is too close to a patient or another C-arm, in the case of a biplane lab. These sensors cause the device to slow down if it nears another object, and stop all motion if a collision occurs. C-arms also integrate a flat detector technology that utilizes an indirect x-ray conversion process, using cesium iodide scintillators. This technology ensures optimal image quality while reducing radiation doses.

All operating tables found in the laboratory are capable of lateral and longitudinal motion (x and y planes). Depending upon the complexity of the surgery and the required angles to obtain a lucid view of the area of interest, some tables move throughout the x, y, and z planes and also have the ability to tilt and swivel. Tables with a tilt option are driven by motor to shield the patient and prevent the table from over-rotating when the patient"s center of gravity is farthest from the central pedestal. All table positions are controlled via joysticks. Many tables now have memory options where physicians can store frequently used table orientations.

Recently, all-digital x-ray catheter laboratory systems have been integrated with PC-based intravascular ultrasound (IVUS) platforms. This new technology allows interventional cardiologists to obtain a clear view of the coronary arteries and detect any irregular confirmations of peripheral vessels. This capability aids clinicians when determining the severity of cardiovascular disease and allows doctors to discern optimal stent placement while providing better guidance throughout therapeutic procedures. With this technology, doctors can ascertain the relative sizes of any lesion and verify the length of any stent. The IVUS platform dramatically reduces the overall size of the console and allows the unit much more variability for optimal placement. This size reduction can be attributed to IVUS"s integrated user interface"s ability to be separated from the console, unlike the current stand-alone systems.

Regulations that apply to catheterization laboratories generally relate to x-ray exposure. All technicians and medical staff are required to wear radiation safety badges and lead aprons when in the presence of radiation. Radiation safety badges should be checked for excess exposure every two months.

Other requirements include appropriate radiation shielding. All walls enclosing any radiation laboratory must be lead trimmed. This regulation is extremely important from a risk management and a patient safety standpoint. Many cath labs now have additional movable lead shields that doctors can use to protect themselves when capturing an image. Finally, each control room must have a lead shield to separate it from the rest of laboratory.

Cath labs are easily managed by conducting routine preventive maintenance (PM) procedures. PMs are usually conducted biannually, but should follow the manufacturer"s recommendations. During these procedures, all equipment is checked for accuracy and calibration. It is also important to check that all equipment is free of debris, dust, and foreign matter while ensuring that all alarms and lights are functioning properly.

Catheterization was first developed when Claude Bernard inserted a mercury thermometer into the carotid artery of a horse in 1844. This procedure was used without x-ray visualization to measure intra-cardiac pressures for the next 40 years. In 1929, Werner Forssmann inserted a urological catheter from an arm vein to the right atrium of a cadaver using only fluoroscopic control and a mirror. Later, Forssmann went so far as to try this experiment on his own arm and x-rayed his own chest. He was the first person to successfully complete a cardiac catheterization and in 1956 won the Nobel Prize for Medicine for his work in heart catheterization, along with co-winners André Frédéric Cournand and Dickinson W. Richards. In the 1940s, Cournand, Hilmert Ranges, and Richards built upon Forssmann"s techniques and used right cardiac catheterization for the investigation of cardiac function in diseased patients. In the 1950s, Sven-Ivar Seldinger developed a new approach for catheterization that pioneered left cardiac catheterization and led to the development of more practical catheters. In 1958, Mason Sones developed a selective coronary angiography procedure utilizing a catheter with a rigid body and curved tip that introduced image and optical amplification technologies.

The majority of equipment failures and errors that occur in catheterization laboratories stem from components that are susceptible to the human touch. A typical catheterization laboratory has many people functioning simultaneously in a fast-paced environment. This hubbub often leads to equipment being knocked over or dropped, cords accidentally being unplugged, C-arms colliding with other equipment in the lab, foot pedals being pushed prematurely, and table side controls becoming dislodged and broken. The best way to avoid these scenarios is to provide better education to the catheterization lab staff about how to safely operate in a busy and fast-paced environment. It is also essential to show the staff how to properly place and position all equipment so that suspended C-arms do not collide with the suspended monitors.

Another common issue that occurs within the laboratory is with communication between devices. This can generally be fixed with a system reboot. Some systems have the option of either a soft or a hard reboot. A hard reboot will solve most problems but completely shuts down the entire system and takes significant time to start back up. A soft reboot will not shut the system down completely and thus will take less time to cycle through, but it will not necessarily clear the problem.

Image quality can also be a common problem during a procedure. When working with flat detector screens, it is not uncommon for an image to “drift” in the monitor screen. If this occurs, check the output of the connections of the monitor screens. Next, calibrate the screen with a light meter. This measures the distribution of the whites and blacks within the screen"s picture. If this distribution becomes out of sync, the monitor will produce a skewed image.

Consensus Document on Catheterization Laboratory Standards. J Am Coll Cardiol. 2001;37(8):2170–2214. Available at www.acc.org/qualityandscience/clinical/consensus/angiography/dirIndex.htm.

In order to service catheterization laboratories, the technician needs to be educated in high-voltage regulations and radiation safety procedures and standards. It is essential the technician knows how to safely shut down a catheterization laboratory in the event of a major equipment failure. One recommended option is using a lock out/tag out procedure if a situation requires that the power to the laboratory be completely shut off at the circuit breaker. In order to ensure that no staff tampers with the high-voltage circuit after the disconnection, the circuit breaker door is labeled and locked with a combination lock that specially assigned to each technician. All manufacturers offer special equipment training that covers all the logistics, functionality, and technicalities of each of their devices.

** The air column detection sensor is designed to aid the user in the detection of air in the injecting line, but it is not designed to replace the vigilance and care required of the operator in visually inspecting for air and clearing air.Call J, Sacrinty M, Applegate R, et al. Automated contrast injection in contemporary practice during cardiac catheterization and PCI: effects on contrast-induced nephropathy. J Invasive Cardiol. 2006;18(10):469-474.

Khoukaz S, Kern M, Bitar S, et al. Coronary angiography using 4 Fr catheters with Acisted power injection. Catheterization and Cardiovascular Interventions. 2001;52:393-398.

Klein LW, Tra Y, Garratt KN, et al. Occupational health hazards of interventional cardiologists in the current decade: results of the 2014 SCAI membership survey. Catheter Cardiovasc Interv. 2015;86(5):913-924.

Holton M. Ergonomics revisited: carpal tunnel syndrome. https://www.cathlabdigest.com/articles/Erogonomics-Revisited-Carpal-Tunnel-Syndrome. Updated March 2005. Accessed: September 26, 2018.

Prior to use, reference Instructions for Use, inside the product carton (when available) or at < enterwebsite.com> for more detailed information on safe use of the device.

The ACIST | CVi™ Contrast Delivery System (CVi system) is not intended for use as a long-term infusion pump. The system is not intended to be used to inject any agents other than contrast media. The system should not be used to inject substances into nonvascular body cavities. Any applications of the system, other than those described in this manual, are inappropriate and should not be attempted. Do not add any components to the consumable kits or in conjunction with the catheter. No valves or other manifolds may be placed in-line between the ACIST-provided consumable kit and the catheter. ACIST-provided consumable kits are designed, manufactured, and tested for connection to catheters used in angiographic procedures. Do not use the system in the presence of flammable gases.

The CVi System is designed to aid the physician in the injection of contrast media during angiography. It should be used with adequate radiographic imaging and where monitoring equipment for blood pressure and the electrocardiogram is available. Additionally, standard equipment for cardiopulmonary resuscitation and drugs for the treatment of contrast media-induced drug reactions should be present.It is necessary that the CVi system be operated by, or be under the immediate and direct supervision of a physician who is specifically trained in angiography and in the operation of this unit. System operation must be monitored at all times, and specific operational and mechanical integrity must be maintained to ensure patient safety.

For proper operation and to ensure equipment compatibility, use only accessories and options provided or specified by ACIST Medical Systems for use with the CVi system. To ensure proper operation of the syringe, viscosity limits must be observed. Do not allow the reusable syringe kit to sit loaded with contrast media longer than the maximum time recommended by the contrast manufacturer. Do not allow the reusable syringe kit to be used for more than five (5) procedures. Replace the automated manifold and hand controller kits after each procedure. Use of the syringe kit for more than five (5) procedures or re-use of the automated manifold and hand controller kits may result in cross contamination, risk of infection or device malfunction, for example, air ingress, leaks, or reduced performance. An air embolism can cause patient injury or death. Operator vigilance and care, along with a defined procedure, are essential to avoid injecting air and causing an air embolism. Before injections, clear all air from the entire patient kit and the angiographic catheter. Make sure that the exterior of the tubing is dry before inserting it into the air column detect sensor. If any fluid is present on the tubing’s exterior surface, the sensor may be unable to detect air. High flow rate injections can cause patient injury or death. Use extreme care when setting the flow rate to avoid unintentionally setting a high flow rate injection. When high flow rate injection is required, be sure to select a pressure setting that does not exceed the rated pressure of the selected catheter.

Surgical monitors and displays are integral to a Hybrid Operating Room environment. These monitors display important information such as patient vital signs, surgical images, and xray images. The placement of these surgical displays around the Hybrid Surgical Suite can take place via ceiling mounted arms, onto equipment management booms, or even wall mounted.

When it comes to HD displays that are used in the Operating Room, some key distinctions exist that make shopping for an HD surgical monitor vastly different from buying an HDTV for the home. Compared to the typical shopping experience for an HDTV for the home setting where there may be a choice of 50 or 60 different models hanging in the retail showroom, stringent FDA regulations greatly narrow the available options that can be placed in a surgical suite.

While an HDTV for your home may look similar to a high-definition surgical display (also referred to as a monitor) designed for the Operating Room, these products are actually quite different from each other, as is their procurement method. Whether you’re shopping for an HD surgical display or an HDTV for the home you’ll want to compare brand features, specifications, size, and price. However, the process of selecting a surgical display for the OR is quite different than an HDTV for the living room.

Confirming that the display meets medical industry standards is essential, when it comes to sanitization and industry equipment standards. Since patient safety and hospital liability are at stake, it is important that the highest quality product is selected. The manufacturer should be an ISO certified, FDA registered company with a quality system fully compliant with rigorous certifications demanded by region-specific regulatory organizations including the FDA.

Surgical-grade monitors are designed for the OR environment, and are built to last. For example, there are no vents, fans, or molded plastic design elements that could temporarily trap airborne particulates, which minimizes the risk of infection for surgical patients. These displays are also VESA compliant and can be either boom arm-mounted or wall-mounted.

The monitors should be lightweight, have sturdy aluminum cases, and have an optical quality polycarbonate cover over the display area. The cable management system should also neatly route video, power and control cables behind a protective cover that is easy to clean.

Purchasing a display that is proven to be compatible with various medical imaging devices is critical, since many imaging devices do not follow video standards and often use proprietary video formats. Video input capabilities are of key importance since they are what determine what types of imaging devices can be connected to the display. For example, in order to view the high resolution video output of most C-arm fluoroscopy machines, the display must have a special SOG (sync-on-green) single BNC input connection.

While choosing a high-quality HD surgical display is the first step to achieving optimal image quality, the way the monitor is integrated with the input source as well as the type of conduit, or wireless, system used will ultimately determine the clarity of what the surgeon sees on the screen.

In order to maximize investment in HD monitors, and ensure surgeons are presented with the sharpest images, requires a three-pronged approach encompassing all of the links in the chain, from the input source, i.e., the camera or endoscope capturing the image, to the conduit or cabling (ideally fiber optic), to the output source, i.e., the monitor/display. Any weak link will compromise the goal of achieving true HD 1080p resolution

Input options include DVI inputs, 3G-SDI inputs, VGA inputs, SOG inputs, or optional single-fiber optic inputs. A video level setting allows the display to "expand" the dynamic range of signals such as SDI, to provide darker black levels and brighter white levels.

To further ensure the integrity of HD signals is maintained from the source equipment all the way through the imaging chain to the display, several principals and guidelines need to be followed. The video signal should never be down-scaled to a lower-resolution as this will dramatically impact the image quality. Conversion of video signals from digital to analog formats should be avoided. If done properly, conversion of analog signals to a digital format such as DVI or SDI will not result in any loss of quality, provided the signal’s resolution is maintained. Integration systems that convert all input signals to one digital format have significant advantages both in terms of cabling simplicity, as well as preservation of image quality.

Healthcare providers should assure that the surgical displays they select are compatible with all the equipment currently in use, and that their integration systems can accommodate future technology.

Displays incorporate a variety of multiple display modes such as Mirror Image, Picture-in-Picture, and Side-by-Side for flexible multi-image viewing. Being able to see multiple images at once such as vital signs, the surgical procedure itself, and radiological images is also incredibly useful in a surgical environment as it helps to reduce clutter. To be able to view multiple images you’ll need to make sure there are multiple inputs on the professional grade display you select.

How colors are displayed is another key distinction for a surgical monitor. The color performance and consistency from display to display is important since clinicians may use these devices as means of making diagnostic decisions based upon the color tone of tissues. High-quality surgical displays are carefully calibrated to produce a true representation of color.

Many consumer displays are tuned toward the red spectrum in an effort to warm the fleshtones of on-camera talent and please consumer tastes; others are tuned for extreme contrast to make movie watching more dramatic. Obviously, this would be unacceptable for medical-grade usage.

New LED backlight stabilization systems can now regulate the backlight to maintain a calibrated luminance output by slowly increasing the backlight drive level as the display ages.

When choosing a wide-screen display consider full capability 1920 x 1080 resolution which is quickly becoming the standard for most endoscopic camera systems. You will also want to choose a monitor that more closely matches the aspect ratio of the images that are captured by the endoscopic camera system. For example, some systems require either a 4:3, 5:4, 16:9, or 16:10 monitor aspect ratio to perform at their optimum level.

Purchasing a display that can quickly and easily be disinfected is important to ensure quick OR turn-around times. OR cost is rated in dollars per minute – at home you have all day to clean your display.

Keywords: Hybrid Operating Room Video Integration, Hybrid Operating Surgical Monitors, Hybrid Operating Room Data Inputs, Hybrid Operating Room Surgical Display, Hybrid Surgical Suite Diagnostic Monitor, Hybrid Operating Room Integrated OR, Hybrid Operating Room Fiber Optic, Hybrid Operating Room Audio/Video, Hybrid Operating Room Video & Audio Routing, Skytron, Stryker, Steris, Berchtold, Maquet, Trumpf, Hybrid Operating Room Black Diamond, Hybrid Operating Room ImageStream, Hybrid Operating Room Barco, Hybrid Operating Room NDS, Hybrid Operating Room Karl Storz, Hybrid Operating Room Sony