Introduction of left ventricular angiography

Directory 1 Pinyin 2 English Reference 3 Operation Name 4 Indications for Left Ventricular Angiography 5 Contraindications for Left Ventricular Angiography 6 Preparation 7 Methods 8 Precautions 1 Pinyin Zu ǒ x ě nshz à o y ǐ ng

2 English reference adventure left adventure

Name of operation: Left ventriculography

4 indications for left ventricular angiography are:

1. Left ventricular obstruction and space occupying lesions.

2. The nature of left ventricular enlargement is unclear.

3. Congenital heart disease, non-cyanotic and cyanotic complex malformation.

4. Aortic valve and mitral valve diseases.

5. Coronary heart disease.

Contraindications 1. Contrast agent and anesthetic allergy.

2. Serious systemic diseases such as severe heart, liver and renal insufficiency.

3. Critical patients with acute massive myocardial infarction or patients with heart failure and refractory arrhythmia (especially ventricular).

4. Symptoms of fever and systemic infection.

6 ready 1. Patient preparation

(1) Explain the imaging purpose, possible complications and accidents to patients and their families, and sign an imaging agreement.

(2) Ask about medical history and examination results, such as electrocardiogram, echocardiography, chest X-ray, CT, MRI, etc. And design a comparison method according to the clinical diagnosis.

(3) Check the heart, liver and kidney functions, as well as blood routine and bleeding and coagulation time.

(4) Iodine and anesthetic should be treated according to the requirements of Pharmacopoeia.

(5) Do not eat for 4 hours before operation. Give sedatives when necessary and give the baby general anesthesia.

(6) Routine skin preparation at the puncture site.

(7) Establish venous access to facilitate intraoperative medication and rescue.

2. Equipment preparation

(1) Cardiovascular X-ray machine, equipped with cinematography, DSA or TV recording equipment.

(2) Disinfection kit for imaging surgical instruments.

(3) Puncture and intubation instruments, such as puncture needle, catheter sheath, catheter, guide wire, etc.

(4) Pressure injector, injector and connecting pipe.

(5) ECG monitor, electronic manometer, cardiac defibrillator, central oxygen supply, anesthesia machine, negative pressure aspirator.

3. Drug preparation

(1) contrast agent: organic iodine water preparation (60% ~ 76% ionic or 300 ~ 370 mgi/ml nonionic).

(2) Anesthetics, anticoagulants and drugs required for cardiac catheterization.

(3) Drugs used to rescue complications and heart diseases.

Method 1. Retrograde insertion of pig tail catheter into left ventricle from femoral artery or brachial artery by percutaneous puncture or incision; The right cardiac catheter enters the left ventricle through the patent foramen ovale of atrial septum or abnormal intracardiac passage.

2. Measure the pressure curve of left ventricle, and observe the continuous pressure curve from left ventricle to ascending aorta and electrocardiogram when necessary; The catheter tip was placed in the middle of the left ventricle for angiography.

3. Injection parameters include contrast agent dosage, 35 ~ 50m l/ time for adults, and flow rate15 ~ 20ml/s; Children should be injected with 1.0 ~ 2.0 ml/kg for 2 s, and the flow rate should not be too high to avoid premature beats.

4. Angiography * * * is positive lateral position or oblique position or axial position (four-lumen position or long-axis oblique position).

5. Is the imaging program DSA? 25 ~ 50 frames/second; Cinematography: 25 ~ 75 frames per second; The injection was delayed by 0.5s. The duration of photography depends on the needs of diagnosis, generally 3 ~ 5s.

6. After angiography, pull out the catheter, apply local pressure 10 ~ 15 min, and then apply pressure to bandage.

7. Photographers should carefully fill in the relevant items and technical parameters of the inspection application form and sign it.

8 precautions 1. Master indications and contraindications.

2. Be prepared before operation.

3. Pay attention to heparinization during catheter operation to prevent thrombosis.

4. Patients with aortic aneurysm should not inject contrast agent into the aneurysm to prevent tumor rupture.

5. Observe the patient's reaction closely and prepare for first aid.

6. Stay in bed for 24 hours after operation, inject antibiotics intravenously, and observe for a certain period of time, paying attention to the possible angiographic complications of patients.

7. Severe arrhythmia and heart failure should not be checked before improvement.

8. Prevention and treatment of the following complications

(1) Complications of puncture and intubation: local hematoma, blood vessel tear, thrombus and air embolism, iatrogenic arterial dissection, and perforation of great cardiac vessels.

(2) Complications of contrast agent: shock, convulsion, spinal cord transection injury, epilepsy and brain edema, laryngeal edema, laryngeal or/and bronchospasm, pulmonary edema, acute renal failure, etc.