Aznaouridis Konstantinos, Masoura Constantina, Kastellanos Stylianos, Alahmar Albert
Konstantinos Aznaouridis, Constantina Masoura, Stylianos Kastellanos, Albert Alahmar, Cardiology Department, Castle Hill Hospital, Hull and East Yorkshire NHS Trust, Cottingham HU16 5JQ, United Kingdom.
World J Cardiol. 2017 Jun 26;9(6):558-561. doi: 10.4330/wjc.v9.i6.558.
We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The catheter was advanced into the left ventricle and a left ventriculogram was obtained, while the catheter appeared optimally placed at the centre of the ventricle and the pressure waveform was normal. A large posterior interventricular vein draining into the right atrium was opacified, presumably because the catheter's end hole inadvertently cannulated an endocardial opening of a small thebesian vein, with subsequent retrograde filling of the epicardial vein. Our case suggests that caution is needed when a dedicated radial catheter with both an end-hole and a side hole is used for a ventriculogram, as a normal left ventricular pressure waveform does not exclude malposition of the end-hole against the ventricular wall.
我们报告一例80岁劳力性心绞痛女性患者，其通过右桡动脉进行冠状动脉造影，使用了专用的桡动脉多功能5F Optitorque Tiger导管。导管推进至左心室并获得左心室造影，此时导管似乎最佳地置于心室中心且压力波形正常。一条汇入右心房的粗大后室间静脉显影，推测是因为导管的端孔无意中插入了一条小的心内膜下静脉的开口，随后心外膜静脉逆行充盈。我们的病例提示，当使用兼具端孔和侧孔的专用桡动脉导管进行心室造影时需谨慎，因为正常的左心室压力波形并不排除端孔相对于心室壁的位置不当。
