A typical Hospital has OPD, IPD, Emergency/ Casualty, Pharmacy, Laboratory and Imaging departments, OT, CSSD, ICU departments (Read for basic common equipment used in a hospital). For a Cardiac Specialty, in addition to regular equipment required for the various departments in the hospital, the following equipment are required, based on the case mix the hospital wishes to handle. A typical Cardiac Hospital would have – a Cath Lab, Cardio Vascular Thoracic Surgery (CVTS) ORs, EP Lab, Cardiac ICU, Physiotherapy & Rehabilitation and specific diagnostic equipment.
Diagnostics & Imaging for Cardiac Set-up
ECG, Echo, Ultrasound and Spirometer are the most common/basic diagnostic equipment available in all cardiac hospitals. Typical diagnostic equipment needed and related procedures that may be done in a cardiac facility are as follows:
- Electrocardiogram (ECG) for 12-lead resting, ambulatory and Stress ECG
- Echocardiography (Cardiac ultrasound) for transthoracic echocardiography (2D, 3D and Doppler echo), Contrast echocardiography, Transesophageal echocardiography, Stress echocardiography etc.
- Ultrasound – investigations of the blood vessels in the neck, arms and legs
- Spirometry to help diagnose and monitor certain lung conditions by measuring how much air one can breathe out in one forced breath.
- Cardiac CT for non-invasive angiography or vascular imaging
- Cardiac MRI
- TMT (Treadmill Test/ Stress Test system)
Catheterization Lab (Cath Lab)
The most basic equipment required in a cardiac unit is the Cath Lab consisting of Angiography X-Ray system. All other advanced systems are used less frequently today in India and their usage depends on the case load and complexity being handled in the hospital.
- Cath Labs – A catheterization laboratory or cath lab is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found. Cath Labs are commonly used for coronary angiography and angioplasty procedures. Popular makes and models in Cath Labs are Philips Allura Xper FD20/10, Philips Allura FC 9, FD 10, Siemens Artis family (Artis Pheno, Axiom Artis, Artis Z, Artis U), Toshiba Infinix 8000, GE Innova, Optima and Discovery family products.
- Intravascular ultrasound (IVUS) for the sonographic visualization or OCT (Optical Coherence Tomography) for Optical Visualization of coronary stenosis. Main IVUS makers are Boston Scientific, Volcano Therapeutics and Terumo. Abbots (St Jude Medical) OCT is popular.
- Intracoronary pressure measurements or Fractional Flow Reserve (FFR) using pressure wires, which is used as an assessment of the severity of coronary stenosis. Cardiac CTs are also getting popular for FFR measurements in a non-invasive manner. Both GE and Siemens have Cardiac CTs.
- Ablation devices such as Excimer laser for the removal of scar tissue as part of device lead extraction procedures involving pacemakers and ICD devices or Rotablator for atherectory (An atherectomy is a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel)
- Electrophysiology systems for the invasive diagnosis and treatment of cardiac arrhythmias
- 3D mapping systems allowing precise visualization and 3D guidance during procedures to treat complex cardiac arrhythmias and pulmonary vein isolation
- Robotic navigation system used in the treatment of complex cardiac arrhythmias and pulmonary vein isolation
CVTS – Operating Room
- Cardiopulmonary bypass – Heart and lung machine or Mini extracorporeal circuit cardiopulmonary (MECC) bypass machine
- Intra-aortic balloon pump (IABP)
- OT Table, OT Light, Anesthesia workstation and Cautery machine
Cardiac Intensive care Unit
- Patient monitors
- Hemodynamic monitoring and management
Physiotherapy & Rehabilitation for Cardiac Hospital
Physiotherapy involved in rehabilitation of Cardiac patient post procedure may involve – Manual therapy and massage, Hot packs and wraps, Hydroelectric bath, massage, Ultrasound therapy, Breathing exercises as well as Treatment on the traction/suspension table.