From Big Medical Encyclopedia

CATHETERIZATION OF HEART (grech, katheter the probe) — introduction to cardial cavities through peripheral veins and arteries of special catheters with the diagnostic and medical purpose. Some authors To. pages call cardiac catheterization that is unreasonable.

For the first time To. page at the person it was executed in 1929 by Forssmann. To widespread introduction To. the page in a wedge, practice were promoted by A. Kurnan's works, and in our country — E. N. Meshalkina, H. N. Malinovsky, V. S. Savelyev, etc.

To. page. apply for diagnosis of difficult heart diseases, specification of indications and contraindications to surgical treatment of a number of heart diseases, vessels and lungs, for identification and assessment of myocardial, coronary and pulmonary insufficiency.

Contraindications: infectious diseases, the expressed heart, pulmonary, liver and renal failure. A contraindication for introduction through a catheter to a circulatory bed of contrast agents (see. Angiocardiography ) hypersensitivity of the patient to iodide drugs serves.

Any special preparation for carrying out To. the page is not required. Usually the research is conducted in the morning on an empty stomach. The patient previously enter 1 — 2 ml of 1% of solution of Promedolum with atropine (0,5 ml of 0,1% of solution). To children the dosage is reduced respectively. The area of an exposure or puncture of a peripheral vessel is infiltrirut 1/2 — 1/4% solution of novocaine. To the impressionable patient and children up to 6 years carry out the general anesthesia.

To. villages carry out in the X-ray operating room with special equipment (see. Operating room ). To. the page are carried out by specially trained doctors.

Technique To. the page is characterized by a big variety of receptions and depends on the purposes and the volume of researches. Distinguish arterial and venous To. page.

Arterial To. pages carry out at a research of an aorta, its branches and the left departments of heart. For its implementation use Seldinger's set consisting of a trocar, elastic conductors and polyethylene tubes. Instead of these tubes often apply Lehmann and Edman's X-ray contrast catheters (red, green, yellow, depending on diameter). These catheters enter into the left departments of heart retrogradno through an aorta by a transdermal puncture of the right femoral artery. Sometimes they will be out through the right humeral artery.

the Roentgenogram of heart with the catheters (simultaneous catheterization of the right and left departments of heart) entered into his cavities: 1 — the catheter through femoral and lower hollow veins is carried out to a right ventricle; 2 — the catheter through a femoral artery and an aorta is carried out to a left ventricle; 3 — the phonographic sensor (it is attached outside to a chest wall).

Venous To. pages carry out at a research of the right departments of heart and a pulmonary trunk. It is carried out by means of tools for veno-section or a special trocar with a set of cannulas. Catheters carry out through the main vein of a shoulder, the right femoral vein, and sometimes use subclavial veins. In certain cases catheterize at the same time left and right departments of heart (fig).

One of kinds of a technique To. the page is a transseptal puncture, at a cut enter a catheter from the right auricle after a preliminary puncture of an interatrial partition into the left auricle a special needle of Ross.

Complications: are possible fibrillation of ventricles of heart with transition to an asystolia, disturbances of a heart rhythm (extrasystoles, blockade, a Bouveret's disease), a spasm of arteries and veins, looping and nodes on a catheter.

Later To. pages patients need within the first days a bed rest.

To. the village allows to study a structure and function of all departments of cardiovascular system and forms a basis for carrying out a number of researches of the central hemodynamics and pulmonary blood circulation.

It is possible to define an exact arrangement and the sizes of separate cardial cavities and large vessels by a catheter, to reveal defects in partitions of heart and an intervascular anastomosis (an open arterial channel, aortolegochny fistulas, etc.), and also to find an abnormal confluence and an otkhozhdeniye of the main vessels (pulmonary veins, an aorta and a pulmonary trunk). Through a catheter it is possible to register pressure curves and a volume blood-groove, an ECG and FKG, and also to receive blood samples for studying of gas structure and other its indicators in all cardial cavities and the main vessels. On a catheter it is possible to enter precisely into any departments of a circulatory bed contrast agents and indicators (dyes, isotopes and others) for determination of minute volume of heart, calculation of size of endocardiac dumpings of blood.

In to lay down. purposes K. villages use for administration of medicines at heart failure, trombolitik — at fibrinferment pulmonary or coronary arteries, himio-drugs — at malignant new growths of lungs. Besides, using special catheters, it is possible to achieve occlusion of an open arterial channel, to expand defects of an interatrial partition at an atresia of the right venous mouth and to eliminate valve stenoses. It is possible that in process of improvement of anemic methods of a research (ultrasound, holography, etc.). To. the page for diagnosis will be applied less often, and with to lay down. purpose, on the contrary, more often.

See also Catheters .

Bibliography: Alekseev G. I. Endocardiac researches in a heart surgery of early children's age, M., 1973, bibliogr.; Volynsk Yu. D. Changes of an endocardiac hemodynamics at heart diseases, L., 1969, bibliogr.; Zaretsky V. V. and H au-voselets S.A. Method of catheterization of the right departments of heart, Grudn. hir., No. 2, page 110, 1971; Malinovsky H. H. Experience of use of angiocardiography and sounding in diagnosis of inborn heart diseases, M., 1959; M e ni and l to and N of E. H. Sounding and contrast research of heart and main vessels, M., 1954, bibliogr.; Petrosyan Yu. S. Catheterization сердца^ at rheumatic defects, M., 1969, bibliogr.; t P at e-N yu with Yu. Yu. Mikrokatetyorization of heart through the left subclavial vein, Vilnius, 1975, bibliogr.; The guide to an angiography, under the editorship of. And. "X. Rabkina, M., 1977; At of l about in F. G., H e to l and with about in Yu. F. and Gerasin V. A. Catheterization of heart and the selection angiocardiography, L., 1974, bibliogr.; Cournand A. Cardiac catheterization, Uppsala, 1975; Cournand A. Ranges H. A. Catheterization of the right auricle in man, Proc. Soc. exp. Biol. (N.Y.), v. 46, p. 462, 1941; De Vi lie pe u ve V. H., SchwandtO. R. a. Stevens P. F. The Philips automated heart catheterization system (ACS), Med. mundi, v. 21, p. 71, 1976, bibliogr.; Forssmann W. Die Sondierung des rechten Herzens, Klin. Wschr., S. 2085, 1929, Bibliogr.; M e n-d e 1 D. A practice of cardiac catheterization, Oxford, 1974; Nygftrds M. E. a. o. On-line computer processing of pressure data from cardiac catheterizations, Com-put. Progr. Biomed., v. 5, p. 272, 1976.

V. V. Zaretsky