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动脉导管未闭患者的降主动脉球囊闭塞血管造影术

[Balloon occlusion descending aorta angiography in patients with patent ductus arteriosus].

作者信息

Wu J R, Huang T Y

出版信息

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1989 Mar-Apr;30(2):105-10.

PMID:2637587
Abstract

Twenty-seven patients, aged 2 months to 3 years, underwent thoracic aorta angiography with balloon inflation during right heart catheterization and cineangiography. The balloon-tipped catheter was manipulated either from the right ventricle to main pulmonary artery and then through patent ductus arteriosus (PDA) or from the right ventricle through ventricular septal defect (VSD) to ascending aorta and to mid-thoracic aorta where the balloon was fully inflated with carbon dioxide. After satisfactory positioning of the inflated balloon, contrast medium was administrated via power injector with a volume of 1.5 ml/kg and a flow rate of 10 ml/sec. Cineangiograms of left lateral projection were obtained. The blood was seen clearly from the thoracic aorta to aortic arch, and also through the PDA to pulmonary vessels. On the late films, left heart chambers were also opacified. Areas of anatomic interest were well visualized in 20 cases of isolated PDA, three of PDA with VSD, two of infantile coarctation of aorta with PDA and VSD, two of tetralogy of Fallot with severe pulmonic stenosis and PDA. This procedure is simple and effective in visualizing the PDA and also, in many occasions, other associated cardiac anomalies. Conventional left heart catheterization and cineangiography could thus be omitted in some cases of congenital heart diseases. There were no untoward complications observed during and after the procedure. This technique is useful especially in critically ill infants.

摘要

27例年龄在2个月至3岁之间的患儿,在右心导管检查和心血管造影期间接受了球囊充盈的胸主动脉造影。带球囊的导管可从右心室操作至主肺动脉,然后通过动脉导管未闭(PDA);或者从右心室通过室间隔缺损(VSD)至升主动脉和胸主动脉中部,在该处球囊用二氧化碳完全充盈。在球囊充盈至满意位置后,通过动力注射器注入造影剂,剂量为1.5 ml/kg,流速为10 ml/秒。获取左侧位心血管造影图像。可清晰看到从胸主动脉至主动脉弓的血流,以及通过PDA至肺血管的血流。在延迟片上,左心腔也显影。在20例单纯PDA、3例PDA合并VSD、2例婴儿型主动脉缩窄合并PDA和VSD、2例法洛四联症合并严重肺动脉狭窄和PDA的病例中,感兴趣的解剖区域显示良好。该方法在显示PDA以及在许多情况下显示其他相关心脏异常方面简单有效。因此,在某些先天性心脏病病例中可省略传统的左心导管检查和心血管造影。在操作期间及之后未观察到不良并发症。该技术尤其对危重症婴儿有用。

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