Transseptal puncture by CTP-2 method: Results from cardiac computed tomography analysis and clinical application.
Transseptal puncture by CTP-2 method: Results from cardiac computed tomography analysis and clinical application.
复制标题
CTP-2法房间隔穿刺：心脏CT分析结果及临床应用
DOI：
10.1097/md.0000000000004504
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发表时间：
2016-08
期刊：
影响因子：
1.6
通讯作者：
Wang DW
中科院分区：
文献类型：
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作者：
Wang Y;Chen G;Bai Y;Li S;Natale A;Dong J;Wang H;Sang C;Yu R;Long D;Tang R;Liu X;Zhao X;Jiang Y;Ma C;Wang DW
目前在透视引导下房间隔穿刺（TSP）所使用的参数来自左心房造影，需要通过精确的解剖测量来验证。2009年2月至2013年7月，连续纳入接受计算机断层扫描（CT）的患者。通过右心房造影对标志点和参数进行了初步研究，并在1001例患者的CT图像上进一步评估。提出了一种用于引导TSP的方法（CTP - 2）。在右前斜45°视图中，CTP - 2方法由C、T和P点以及2个区域定义：C点位于冠状窦；T点在C点上方距离为dCT（通常为1.5 ± 0.2个椎体高度）处；然后P点，即最佳穿刺点，位于T点后方0.5 ± 0.2个椎体高度处；穿刺应避开主动脉根部区域和后三角区域；主动脉根部区域可通过下腔静脉开口处的右心房造影负性显影，后三角区域由C、C′和T′点界定（C′和T′分别是C点和T点水平向后且距离为dCT的两个点）。CTP - 2在2820例患者中的初步应用表明，它可能有助于减少左心房造影的需求以及心脏穿孔的可能性。
AbstractThe current used parameters for transseptal puncture (TSP) under fluoroscopic guidance is from left atriography and need to be verified by precise anatomic measurement. From February 2009 to July 2013, consecutive patients who received computed tomography (CT) were included. Landmarks and parameters were preliminary studied by right atriography, and further evaluated on the CT images of 1001 patients. A method (CTP-2) was proposed for guiding TSP. In right anterior oblique 45° view, the CTP-2 method was defined by points C, T, and P, and 2 areas: point C is in coronary sinus; point T is at a distance of dCT (usually 1.5 ± 0.2 vertebral height) over point C; then point P, the optimal puncture site, was located at 0.5 ± 0.2 vertebral body height posterior to point T; puncture should avoid the aortic root area and the rear triangle area; the aortic root area could be negatively revealed by right atriography at the orifice of inferior vena cava, and the rear triangle area is demarcated by points C, C′, and T′ (C′ and T′ are 2 points horizontally posterior to, and at dCT away from points C and T, respectively). The initial application of CTP-2 in 2820 patients showed that it might be helpful in reducing the need of left atriography and the possibility of cardiac perforation.