Kwaan J H, McCart P M, Jones S A, Connolly J E
Surg Gynecol Obstet. 1977 Jun;144(6):919-21.
The placement of a Swan-Ganz catheter into the abdominal vena cava by the femoral route is recommended for all patients presenting with severe congestive heart failure and an abdominal aortic aneurysm. If an aortocaval fistula exists, its presence can be determined immediately by noting increased vena caval pressure and higher than normal oxygen content. Immediate recognition of this condition is essential. Fluid overloading is avoided, immediate surgical treatment is instituted and the defect is closed. Minimal manipulation is done in an effort to prevent pulmonary embolization. If the results of catheter studies show no evidence of an aortocaval communication, it may be advisable to make an effort to correct the congestive heart failure before surgically correcting the aneurysm.
对于所有患有严重充血性心力衰竭和腹主动脉瘤的患者，建议经股动脉途径将 Swan-Ganz 导管置入腹静脉。如果存在主动脉腔静脉瘘，可通过观察腔静脉压力升高和氧含量高于正常水平立即确定其存在。立即识别这种情况至关重要。避免液体超负荷，立即进行手术治疗并封闭缺损。尽量减少操作以防止肺栓塞。如果导管检查结果显示无主动脉腔静脉交通的证据，在手术矫正动脉瘤之前努力纠正充血性心力衰竭可能是可取的。
