Division of General Internal Medicine, Hackensack Meridian School of Medicine at Seton Hall University, Jersey Shore University Medical Center, Neptune, New Jersey.
Division of Thoracic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Jersey Shore University Medical Center, Neptune, New Jersey.
Ann Thorac Surg. 2019 Apr;107(4):e297-e299. doi: 10.1016/j.athoracsur.2018.09.072. Epub 2018 Nov 14.
When hemodynamic instability occurs during transcatheter aortic valve replacement, peripheral cardiopulmonary bypass is required. The pigtail catheter, initially placed through the femoral artery to direct placement of the valve, is exchanged over a wire for an arterial bypass cannula. Other than time-consuming arterial cut-down procedures in hypotensive patients, there are few techniques described to allow the operator to continue bypass and complete transcatheter aortic valve replacement. This report describes a method to reintroduce the pigtail catheter by puncturing the arterial bypass cannula. This technique allows the operator to support the patient, continue bypass, and successfully place the valve without aborting the procedure.
当经导管主动脉瓣置换术期间发生血流动力学不稳定时，需要外周心肺转流。最初通过股动脉放置的猪尾导管用于引导瓣膜放置，通过导丝更换为动脉旁路插管。除了低血压患者耗时的动脉切开术程序外，很少有技术可用于允许操作者继续旁路并完成经导管主动脉瓣置换术。本报告描述了一种通过刺穿动脉旁路插管重新引入猪尾导管的方法。该技术允许操作者支持患者，继续旁路，并成功放置瓣膜，而不会中断手术。
