La. Admin. Code tit. 48 § I-2349

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Current through Register Vol. 50, No. 11, November 20, 2024

Section I-2349 - Cardiology Procedures

A. Arterial Line Insertion

1. swelling, pain, tenderness or bleeding at blood vessel entrance by catheter or needle;

2. injury to artery or vein entered or studied;

3. decrease in blood flow to area supplied by the artery;

4. nerve damage;

5. loss or loss of function of an arm or leg supplied by the artery;

6. possible need for surgery due to complications.

B. Cardiac Catheterization

1. death;

2. myocardial infarction (cardiac arrest/heart attack);

3. cerebrovascular complication (stroke);

4. injury to artery or vein entered or studied;

5. local, vascular complication (groin or arm);

6. bleeding, thrombosis, distal embolization, pseudoaneurysm, arteriovenous (AV) fistula (abnormal communication between an artery and a vein), hematomas, nerve damage, injury to the artery, delayed hemorrhage;

7. loss or loss of function of an arm or leg;

8. perforation of heart or great vessels;

9. vasovagal reaction (hypotension, slow heart rate);

10. arrhythmias and conduction disturbances (irregular heart beat);

11. kidney failure (partial or complete; may necessitate hemodialysis);

12. contrast related anaphylactoid reactions (allergies);

13. congestive heart failure;

14. pulmonary embolism;

15. bleeding requiring blood transfusion or surgery;

16. possible need for surgery due to complications;

17. scar formation at the site of entrance into the artery.

C. General Angiography

1. contrast related anaphylactoid reactions (allergies);

2. injury to artery or vein entered or studied;

3. loss or loss of function of an arm or leg;

4. kidney failure (partial or complete; may necessitate hemodialysis).

D. Percutaneous Coronary Angioplasty/Stent Placement

1. death;

2. brain damage (stroke);

3. quadriplegia;

4. paraplegia;

5. injury to artery or vein entered or studied;

6. loss or loss of function of an arm or leg;

7. disfigurement (including scars);

8. kidney failure (partial or complete; may necessitate hemodialysis);

9. loss of bowel and/or bladder function;

10. myocardial infarction (cardiac arrest/heart attack);

11. restenosis (subsequent recurrence of narrowing of blood vessel);

12. possible need for surgery due to complications;

13. contrast related anaphylactoid reactions (allergies);

14. hypotension (abnormally low blood pressure);

15. arrhythmias and conduction disturbances (irregular heart beat);

16. bleeding requiring blood transfusion or surgery;

17. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

18. stent thrombosis;

19. displacement of stent or instrument requiring retrieval.

E. Thrombolysis-Regional or Systemic

1. death;

2. brain damage (stroke);

3. injury to artery or vein entered or studied;

4. loss or loss of function of an arm or leg;

5. bleeding requiring blood transfusion or surgery;

6. hematoma;

7. arrhythmias and conduction disturbances (irregular heart beat);

8. hypotension (abnormally low blood pressure);

9. contrast related anaphylactoid reactions (allergies).

F. Coronary Intervention (Stents and Atherectomy)/Directional Coronary Arthrectomy (DCA), Transluminal Extraction Catheter Arthrectomy (TEC) and Rotational Atherectomy

1. death;

2. brain damage (stroke);

3. quadriplegia;

4. paraplegia;

5. injury to artery or vein entered or studied;

6. loss or loss of function of an arm or leg;

7. disfigurement (including scars);

8. kidney failure (partial or complete; may necessitate hemodialysis);

9. loss of bowel and/or bladder function;

10. myocardial infarction (cardiac arrest/heart attack);

11. restenosis (subsequent recurrence of narrowing of blood vessel);

12. possible need for surgery due to complications;

13. contrast related anaphylactoid reactions (allergies);

14. hypotension (abnormally low blood pressure);

15. arrhythmias and conduction disturbances (irregular heart beat);

16. bleeding requiring blood transfusion or surgery;

17. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

18. side branch occlusion;

19. severe bradycardia (severe slowing of the heart);

20. stent thrombosis;

21. displacement of stent or instrument requiring retrieval;

22. perforation of heart or great vessels;

23. coronary vasospasm related to the instrument used.

G. Electrophysiologic Study Including Programmed Electrical Stimulation (EPS) (Stimulating the heart to search for abnormal heart beat)

1. perforation of heart or great vessels;

2. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

3. bleeding requiring blood transfusion or surgery;

4. injury to artery or vein entered or studied;

5. arrhythmia and conduction disturbances (irregular heart beat);

6. pneumothorax (collapse of lung);

7. death;

8. myocardial infarction (cardiac arrest/heart attack);

9. bleeding, thrombosis, distal embolization, pseudoaneurysm, arteriovenous (AV) fistula (abnormal communication between an artery and a vein), hematomas, nerve damage, injury to the artery, delayed hemorrhage;

10. thrombophlebitis (inflamation of the vein);

11. pulmonary embolism (blood clot from pelvis or legs that moves to lungs);

12. brain damage (stroke);

13. loss or loss of function of a leg or arm;

14. electrical burns to the chest.

H. Radiofrequency Catheter Ablation

1. perforation of heart or great vessels;

2. injury to artery or vein entered or studied;

3. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

4. bleeding requiring blood transfusion or surgery;

5. pneumothorax (collapse of lung);

6. death;

7. myocardial infarction (cardiac arrest/heart attack);

8. arrhythmia and conduction disturbances (irregular heartbeat);

10. thrombophlebitis (inflamation of the vein);

11. pulmonary embolism (blood clot from pelvis or legs that moves to lungs);

12. brain damage (stroke);

13. loss or loss of function of a leg or arm;

14. electrical burns to the chest;

15. possible need for surgery due to complications;

16. damage to heart valve;

17. interruption of the normal electrical conduction system of the heart, requiring permanent pacemaker placement;

18. recurrence of arrhythmia after initially successful ablation.

I. Transesophageal Echocardiography

1. arrhythmias and conduction disturbances (irregular heartbeat);

2. myocardial infarction (cardiac arrest/heart attack);

3. aspiration pneumonia;

4. respiratory failure which may require ventilation;

5. trauma to vocal cords which may result in temporary or permanent vocal cord injury that may require surgical repair;

6. injury to artery or vein entered or studied;

7. injury to teeth, gums, or throat, esophageal bleeding, laceration or perforation which may require surgical repair.

J. Exercise Treadmill and Bicycle Stress Testing

1. death;

2. myocardial infarction (cardiac arrest/heart attack);

3. arrhythmias and conduction disturbances (irregular heartbeat);

4. prolonged angina (chest pain);

5. hypotension/hypertension (abnormally low blood pressure/high blood pressure);

6. brain damage (stroke);

7. syncope (fainting);

8. musculoskeletal injuries (injuries to bones, muscles, and/or joints).

K. Dobutamine Stress Testing

1. death;

2. myocardial infarction (cardiac arrest/heart attack);

3. prolonged angina (chest pain);

4. hypotension/hypertension (abnormally low blood pressure/high blood pressure);

5. brain damage (stroke);

6. arrhythmias and conduction disturbances (irregular heartbeat);

7. syncope (fainting);

8. injury to artery or vein entered or studied.

L. Automatic Implantable Cardioverter Defibrillator Implantation (Permanent Pacemaker)

1. bleeding requiring blood transfusion or surgery;

2. hemorrhage (bleeding) into the lungs, the pericardium (sac which surrounds the heart), and the chest cavity;

3. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

4. myocardial infarction (cardiac arrest/heart attack);

5. brain damage (stroke);

6. pneumothorax (collapse of lung);

7. perforation of heart or great vessels;

8. injury to artery or vein entered or studied;

9. possible need for surgery due to complications;

10. arrhythmia and conduction disturbances (irregular heart beat);

11. damage to trachea (windpipe) and/or pharynx (throat);

12. trauma to vocal cords which may result in temporary or permanent vocal cord injury that may require surgical repair.

M. Pericardiocentesis

1. perforation of heart or great vessels;

2. damage to coronary arteries including laceration;

3. possible need for surgery due to complications;

4. arrhythmia or conduction disturbances (irregular heart beat);

5. myocardial infarction (cardiac arrest/heart attack);

6. pneumothorax (collapse of lung);

7. death;

8. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart).

N. Electrical Cardioversion

1. electrical burns to the chest;

2. myocardial infarction (cardiac arrest/heart attack);

3. embolic event to any portion of the body (e.g., brain, bowel, kidney, eyes, arm, leg) which may lead to loss of, or loss of function of, affected portion of body;

4. injury to artery or vein entered or studied;

5. death;

6. brain damage (stroke);

7. arrhythmia and conduction disturbances (irregular heartbeat).

O. Endomyocardial Biopsy

1. injury to artery or vein entered or studied;

2. hemorrhage (bleeding) into the lungs, the pericardium sac which surrounds the heart and the chest cavity;

3. pericardial tamponade (compression of the heart due to accumulation of blood in the sac around the heart);

4. myocardial infarction (cardiac arrest/heart attack);

5. arrhythmias and conduction disturbances (irregular heartbeat);

6. pneumothorax (collapse of lung);

7. perforation of heart or great vessels;

8. possible need for surgery due to complications;

9. damage to trachea (windpipe) and/or pharynx (throat);

10. trauma to vocal cords which may result in temporary or permanent vocal cord injury that may require surgical repair;

11. displacement of stent or instrument requiring retrieval;

12. brain damage (stroke);

13. bleeding requiring blood transfusion or surgery.

P. Temporary Pacemaker Placement

1. injury to artery or vein entered or studied;

2. hemorrhage (bleeding) into the lungs, the pericardium (sac which surrounds the heart), the chest cavity and elsewhere;

3. pericardial tamponade (compression of the heart due to accumulation of blood or fluid in the sac around the heart);

4. brain damage (stroke);

5. myocardial infarction (cardiac arrest/heart attack);

6. pneumothorax (collapse of lung);

7. perforation of heart or great vessels;

8. possible need for surgery due to complications;

9. arrhythmia and conduction disturbances (irregular heartbeat);

10. trauma to vocal cords which may result in temporary or permanent vocal cord injury that may require surgical repair;

11. displacement of stent or instrument requiring retrieval.

Q. Pulmonary Angiogram and/or Right Heart Catherization

1. injury to artery or vein entered or studied;

2. hemorrhage (bleeding) into the lungs, the pericardium (sac which surrounds the heart) and the chest cavity;

3. brain damage (stroke);

4. pneumothorax (collapse of lung);

5. myocardial infarction (cardiac arrest/heart attack);

6. perforation of heart or great vessels;

7. possible need for surgery due to complications;

8. arrhythmia and conduction disturbances (irregular heart beat);

9. shock;

10. infusion of fluid into the chest cavity, lungs, and pericardium;

11. contrast related anaphylactoid reactions (allergies);

12. death;

13. aggravation of the condition that necessitated the procedure;

14. bleeding requiring transfusion or surgery;

15. kidney failure (partial or complete; may necessitate hemodialysis);

16. respiratory complications (including need for prolonged ventilator (mechanical) support);

17. loss or loss of function of an arm or leg.

R. Cardiac Rehabilitation

1. death;

2. arrhythmias and conduction disturbances (irregular heartbeat);

3. myocardial infarction (cardiac arrest/heart attack);

4. prolonged angina (chest pain);

5. hypotension/hypertension (low blood pressure/high blood pressure);

6. brain damage (stroke);

7. syncope (fainting);

8. musculoskeletal injuries (injuries to bones, muscles and/or joints);

9. drowning (if involving water activities).

S. Head up Tilt Test (Including vasoactive drugs)

1. syncope (fainting);

2. seizure (convulsions);

3. hypotension/hypertension (low blood pressure/high blood pressure);

4. arrhythmia and conduction disturbances (irregular heartbeat);

5. myocardial infarction (cardiac arrest/heart attack)

6. brain damage (stroke).

La. Admin. Code tit. 48, § I-2349

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Medical Disclosure Panel, amended LR 25:1651 (September 1999).

AUTHORITY NOTE: Promulgated in accordance with R.S. 40:1299.40.E et seq.