Feasibility of in vivo pressure measurement using a pressure-tip catheter via transventricular puncture.
Feasibility of in vivo pressure measurement using a pressure-tip catheter via transventricular puncture.
复制标题
使用压力尖端导管通过心室穿刺进行体内压力测量的可行性。
DOI：
10.1097/mat.0b013e3181d823a1
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Spotnitz,HenryM
中科院分区：
文献类型：
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作者：
Gray,RobertG;Cabreriza,SantosE;Quinn,TAlexander;Weinberg,AlanD;Spotnitz,HenryM
压力尖端导管(PTCs)用于评估儿童先天性心脏病手术中的心室力学。在婴儿身上进行的研究需要微型传感器。我们比较了2-Fr超小型PTC和5-Fr PTC的安全性和准确性。在10只仔猪(体重19-22公斤)上，用11号刀片通过3 mm的根尖穿刺点置入5-Fr PTC。使用另一个单独的部位插入了一个20号血管探测仪。2-Fr PTC被穿过血管测量仪的管腔。收回血管测量仪，将2-Fr PTC留在左心室(LV)内。测定3次下腔静脉闭塞期间左心室内压(LVP)的变化。2-Fr PTC和5-Fr PTC对LV舒张末压力(0.90~0.95)、最大LVP(0.92~0.99)、最大LVP(0.87~0.93)和最小一阶导数(0.89~0.94)的信度系数呈正相关。Bland-Altman分析表明所有变量都是一致的。通过压力操纵和导管放置和拔出，出血很少。使用2-Fr PTC的压力测量是准确的，与5-Fr PTC的测量结果相当。经脑室放置2-Fr经皮冠状动脉腔内成形术是可行的，应该可以在先天性心脏病手术修复期间评估室壁力学。
Pressure-tip catheters (PTCs) are used to evaluate ventricular mechanics during surgical repair of congenital heart disease in children. Studies in infants require miniaturized sensors. We compared the safety and accuracy of a 2-Fr ultraminiature PTC with a 5-Fr PTC. In 10 piglets (weight 19–22 kg), a 5-Fr PTC was inserted through a 3-mm apical puncture with a# 11 blade. A 20-gauge angiocatheter was inserted using a separate site. A 2-Fr PTC was threaded through the angiocatheter lumen. The angiocatheter was withdrawn, leaving the 2-Fr PTC within the left ventricle (LV). Left ventricular pressure (LVP) changes were measured during three inferior vena caval occlusions. Reliability coefficients demonstrated correlation between the 2-Fr PTC and 5-Fr PTC for LV end-diastolic pressure (0.90–0.95), peak LVP (0.92–0.99), and the maximal (0.87–0.93) and minimal (0.89–0.94) first derivatives of LVP. Bland-Altman analysis demonstrated agreement for all variables. Blood loss was trivial with pressure manipulation and catheter placement and removal. Pressure measurements using the 2-Fr PTC were accurate and comparable with those from the 5-Fr PTC. Transventricular placement of a 2-Fr PTC is feasible and should allow evaluation of ventricular mechanics during surgical repair of congenital heart disease.