right heart catheterization. A new catheter for ...

A new catheter for percutaneous transfemoral right heart catheterization. J Mehta and R I Hamby Chest 1975;68;86-87 DOI 10.1378/chest.68.1.86 The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://chestjournal.chestpubs.org/content/68/1/86

Chest is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright1975by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder. (http://chestjournal.chestpubs.org/site/misc/reprints.xhtml) ISSN:0012-3692

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[*1

t

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t[s1

A New

Catheter

Heart

Catheterization* Mehta,

M.D.,

catheter for

used

percutaneous

is

described.

recording.

Because

techniques a brachial

using described

in

widely

for right or femoral

the

femoral

and

Both

in different

The

techniques

cardiac

need

using

to sacrifice this

the

approach

transfemoral

brachial

combined

arterial

vein.

Furthermore, percutaneous

catheterization

makes

describe

a new

approach

cathether

to right

angiography,

heart

and

for

a more

was

over

of le.ft not has

may

be used,

in right

heart

the

technical

femoral feasible.

The

previously

is passed to the the guidewire.

is withdrawn

and

the

ease.

vein

when

right In

takes

and

of

we

femoral

right

described.24

atrium, the right

catheter

a trial

Occasionally, the

technique been

suggest

we

catheterization

the

right

fe-

Once

the

the catheter atrium, the its

is adguide-

double-curved

perreport,

simplified

catheterization,

pulmonary

catheter

it possi-

ble to perform an entire cardiac catheterization cutaneously via the femoral vessels. In this we

wire

the

approach

guidewire vanced

percutaneous and avoiding

this

because

moral

seems

with

which

by physicians involved pulmonary angiography.

preferred

are

however,

F.C.C.P.

have used approach

catheterization

approach,

to be more popular because of the technique utilized, thereby saving time the

be

wedgeefficiency

pulmonary

Right

with

heart also

heart catheterization approach have been

literature.15

used

laboratories.

can

speed

the

M.D.,

right

catheter and

of

Transfemoral

I. Hamby,

transfemorni

angiography

S everal

Robert

The

pulmonary

pressure

now

and

for

catheterization

[I

for Percutaneous

Jawahar

A new

T1 iuiii

f*(-Is

pulmonary

wedge-pressure

re-

cording. MATERIALS The

8

catheter

to

(The

110-cm

side

long

holes,

two

catheter,

with

obtaining

the

the

for

1.36mm.

The

at

distal

There

from

the

tip

open

end

and

no

is

to

reduced last

tip

limb

1.5

of

the

The

limb.

cm.

side

The 7

effective to allow a

0.045

9 cm

size

inch

of tip

is

guidewire.

cm shorter of conventional

curve

is 1

is made catheter

distal

with the internal diameter

French

second

angiographic

and

The

catheter

type,

end and four two at 1 inch. The holes, is used for

open

pressure. a

tapered

is

is a French

is an

Ii inch

wedge

the

polyethylene

Corporation),

1).

pulmonary

The

proximal

(Fig

only

catheter

tapered

Cordis

than the flexible

material.

TECHNIQuE In heart either

our

laboratory,

catheterization of

the

we

have

performed

procedures femoral

veins.

with A

right

over this femoral

1,200

catheter,

right using

approach

#{176}From the Department of Medicine, Cardiology Division, Long Island Jewish-Hillside Medical Center, New Hyde Park, N.Y., Queens Hospital Center Affiliation, Jamaica, N.Y. and the School of Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY. Reprint requests: Dr. Mehta, Long Island Jewish-Hillside Medical Center, New Hyde Park, New York 11040

86

MEHTA, HAMBY

is

Ficuna signed

1. Percutaneous to facilitate

right

transformal right heart catheterization.

heart

catheter

de-

CHEST, 68: 1, JULY, 1975


The

procedure

nary

artery

proximately

pulmonary

the

guidewire

advanced

after

pulmonary

with

tive

the

holes

the in

angiography

over

the

can

the

pulmo-

requiring

venous

the

ap-

puncture

is

is required, pulmonary

be

required

in

usually

angiography

side

in

catheter

rapidly,

minute

case

In

catheter

positioning

accomplished

one

formed. the

of

is

we

place

artery.

performed

segment

Selec-

by

and

per-

the

directing catheter

is

it.

DIscussIoN In A.

our

experience

whom this terization,

B.

catheter in three

with

catheter there

over

was used for were no failures

to the level of the patients, one with

one with tricuspid atresia atrium. There were no damage irritative or

fects

which

occasional

diac

procedure.

foration

heart cathepassing the

vein such expected

There

was

the

use

this

conduction in any

no

of this

of

a huge right in terms of

or to the heart except as premature contrac-

to be

advantage

case

FIGun moved. valve.

2a. b.

car-

of cardiac

per-

catheter.

catheter

seems

to

and

Catheter

(Fig

2a).

the

across

the

right

pulmonary catheter

the

artery

requiring

some

be

advanced

guidewire.. is

the

withdrawn

68:

is

tricuspid

pulmonary

to

(Fig

Mrs.

Roberta

technical

Cogen

connected

1, JULY,

thank

We Mr.

and

Mr.

Steven Shapiro

Sidney

B.

Levine, their

for

assistance.

artery,

of

its

open

pressures,

end and

pressure

therein.

the

1

is

2 3

The

right

Grollman

After is and

Gyepes

1968,

Jr.

pp

A modified

MT.

technique

Helmer

E:

JE,

of

right

heart

catheterization.

DT,

Hoffman

RB,

RK:

pulmo-

Transfemoral

selec-

a pulmonary

96:202-204,

Gray

1970

Percutaneous Am

2),

1971 with

Radiology

Price

(ed 11-20

100:425-427,

arteriography

catheter.

JH

J Cardiol

trans30:646-

1972

of percutaneous

A NEW CATHETER FOR PERCUTANEOUS

DC:

pulmonary

seeking

Desilets Ther

Catheterization

Thomas, Radiology

JH,

Grollman 647,

5

C

Levin

bilateral

femoral

catheter ventricle,

4

catheter

monitor. the

the

HA,

artery

can

Intravascular C

arteriography.

tive

over

HA: Ill.,

Baltaxe nary

the

catheter the

Zimmerman Springfield,

tip

2c).

position

pressure, artery,

tip, right

occasionally

wedge the

the to

guidewire,

removed

the

Once

2b).

(Fig

The

pulmonary

1975

in

branches

2d).

wedge the

that

advanced

the

to

so seen

is

over

is then

pulmonary recording

(Fig

pulmonary

guidewire

main

is

guidewire

one

to the

rotated

valve

the

rotation

to the

atrium,

CHEST,

to

intensifier,

advanced

and

flushed

catheter

and

The

recording right

guidewire,

image

ventricle,

is simply

easily

its

cathe-

REFERENCES

The

under

ventricle,

over

ACKNOWLEDGMENTS:

is removed.

visualized in

advanced

guidewire

shape

in right atrium after guidewire is reas seen in right ventricle across tricuspid is advanced to pulmonary artery. d.

Guidewire is

be

heart

D.

Catheter

c.

Catheter

de-

invasive

speed and efficiency in performing right terization and pulmonary angiography. C.

in

pulmonary artery, except severe tricuspid stenosis,

interventricular

are

with

The

patients,

right in

and one with complications

to the femoral phenomenon

tions

1,200

NucI

Ruttenberg

catheterization. Med

95:519-522,

TRANSFEMORAL

Am

HD:

A new

J Roentgenol

method Radium

1966

RIGHT HEART CATHETERIZATION


81

A new catheter for percutaneous transfemoral right heart catheterization. J Mehta and R I Hamby Chest 1975;68; 86-87 DOI 10.1378/chest.68.1.86 This information is current as of April 12, 2012 Updated Information & Services Updated Information and services can be found at: http://chestjournal.chestpubs.org/content/68/1/86 Permissions & Licensing Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.chestpubs.org/site/misc/reprints.xhtml Reprints Information about ordering reprints can be found online: http://www.chestpubs.org/site/misc/reprints.xhtml Citation Alerts Receive free e-mail alerts when new articles cite this article. To sign up, select the "Services" link to the right of the online article. Images in PowerPoint format Figures that appear in CHEST articles can be downloaded for teaching purposes in PowerPoint slide format. See any online figure for directions.
