A technique that reduces risk of blood-borne infection to doctors while performing cardiovascular interventions
Interventional cardiologists and interventional radiologists are known to be exposed to the risk of blood-borne infections during cardiovascular interventions, especially during arterial puncture to gain access to the arterial system. However, a Mohali-based cardiologist claims to have found a solution to the problem.
Senior cardiologist H.K. Bali said: “Arterial access is mandatory for all coronary and peripheral vascular diagnostic and interventional procedures. The risk of blood coming in contact with the operator is negligible during a venous puncture as it is carried out with the needle attached to the syringe. But the arterial puncture has to be carried out with the needle only and the risk arises when the needle punctures the artery and blood spurts out of it at arterial pressure and comes in contact with the operators’ hands.’’
He added: “After the puncture, a guide wire is passed through the needle into the artery, needle is withdrawn and a valved sheath is securely placed in the artery. All the subsequent procedures are carried out through this valved sheath. Despite all precautions, including using double gloves, the risk of blood borne infections such as different types of Hepatitis (B, C) and HIV cannot be completely excluded and these obviously have serious consequences.’’
Dr. Bali said that many a time some of these interventional procedures have to be carried out even before the reports of blood investigations were available to the operator. For example, most of the primary angioplasties to treat acute heart attack have to be carried out before any blood investigation report is available. Also, the law prohibited evaluating the HIV status of a patient without his explicit consent.
Speaking about the technique developed by him to reduce the risk, he said: “It uses commonly and routinely available material in the catheterization lab. By using a combination of puncture needle, Tuohy Borst (a proprietary valved adapter which provides a leak-proof seal during interventional and diagnostic procedures), plastic tubing and guide wire, the arterial puncture can be carried out without any contact of blood with the operator. It is easy to learn and takes only a couple of minutes to carry out. It is entirely safe and effective. There is no extra cost to the patient or the hospital.” The technique involves no blood loss and can be used on newborns and children undergoing catheterization, according to Dr. Bali.