Frazin L J, Vonesh M J, Khasho F, Lanza G, Chandran K B, Talano J V, McPherson D D
Department of Medicine, Northwestern University, Chicago, Illinois 60611.
Cathet Cardiovasc Diagn. 1992 May;26(1):41-50; discussion 50-2. doi: 10.1002/ccd.1810260110.
A Doppler guided retrograde catheterization system was developed to accurately catheterize the aortic root and left ventricular chamber without X-ray. This system consists of a 20 MHz, 0.076 mm thick x 1.016 mm diameter pulsed Doppler crystal integrated into the tip of a 100 cm multipurpose triple lumen catheter. Two lumens (0.61 mm) are used for electrodes; a third lumen (1.245 mm) may be used for guidewire and pressure determination; and the system is attached to a flow velocimeter. In an aortic arch flow model, the principles of Doppler signal guidance were confirmed with flow toward the catheter tip demonstrating positive signals and flow away from the catheter tip demonstrating negative signals. The magnitude and polarity (direction) of the detected phasic and mean velocities were utilized to guide catheterization in six dogs. Using the reversal of Doppler signal polarity to indicate branch entry and manipulating the catheter so as to maintain maximal positive axial velocity, the Doppler catheter was successfully advanced from the femoral artery to the aortic valve. Branches detected by the Doppler system were confirmed by fluoroscopy. The aortic valve was audible when approached and the left ventricular chamber was recognized by its characteristic pressure waveform. The Doppler guided retrograde catheterization system offers new technology to perform left heart catheterization without X-ray and may prove useful in a variety of settings including the development of invasive ultrasonic diagnostic and therapeutic technology.
一种多普勒引导逆行导管插入系统被开发出来，以便在无X射线的情况下准确地将导管插入主动脉根部和左心室腔。该系统由一个集成在100厘米多用途三腔导管尖端的20兆赫、0.076毫米厚×1.016毫米直径的脉冲多普勒晶体组成。两个管腔（0.61毫米）用于电极；第三个管腔（1.245毫米）可用于导丝和压力测定；并且该系统连接到血流速度计上。在一个主动脉弓血流模型中，多普勒信号引导的原理得到了证实，朝向导管尖端的血流显示为正信号，远离导管尖端的血流显示为负信号。检测到的相位和平均速度的大小和极性（方向）被用于指导六只狗的导管插入。利用多普勒信号极性的反转来指示分支入口，并操纵导管以保持最大的正向轴向速度，多普勒导管成功地从股动脉推进到主动脉瓣。通过荧光透视法证实了多普勒系统检测到的分支。接近主动脉瓣时可听到声音，通过其特征性压力波形识别左心室腔。多普勒引导逆行导管插入系统提供了一种在无X射线的情况下进行左心导管插入的新技术，并且可能在包括侵入性超声诊断和治疗技术发展在内的各种情况下证明是有用的。
