经皮激光心肌打孔术中左心室造影定位方法学探讨

The Reserch of Locate Methods in Left Ventracular Angiography of PMR

目的探索经皮激光心肌打孔血运重建术（ＰＭＲ）中左心室造影定位方法。方法应用不同的记录模式对１２例行ＰＭＲ治疗的病患者进行左心造影打孔区定位检查。结果１２例冠心病患者ＰＭＲ治疗均获成功，无任何并发症发生。结论①左心室造影中６例应用ＣＳＰ模式记录，６例应用ＤＣＩ＋ＭＡＰ模式记录，均可记录到满意的左心室双期图像。②ＰＭＲ术中利用左心室腔轮廓和骨性结构标志进行定位时，ＤＣＩ＋ＭＡＰ模式优于ＣＳＰ模式。③每次造影以造影剂总量３５ｍｌ、速度１２～１７ｍｌ／ｓ、压力７５０ＰＳＩ为宜。造影剂，最好选用非离子型。④选择高压注射器的Ｒ波触发造影，可减少造影过程中心律失常的发生，提高造影的成功率。⑤投照角度固定应用双斜位，右前斜位３０度，左前斜位６０度。

Purpose Reserch the methods of left ventricular angiogaphy in percutanceous laser myocardium revascularization(PMR).Methods Use different mode to record left ventracular angiography image in 12 case CHD PMR.Results 12 case PMR were performed successful and there were no any complication.Conclusion Our work suggests that:①6 case LV angiography record in CSP mode and other in DCI+MAP mode,all of image is satisfactory.②DCI+MAP mode is better than CSP mode in PMR procedure.③It is best to injected angiographein 35ml、speed 12～17ml/s、pressure 750PSI every time.④Choose ECG R wave synergic angiography can reduce arrhythmia.⑤Fixed RAO 30 degree and LAO 60 degree is necessary in order to compare image and further compute take. [