Berman导管在复杂心血管畸形造影诊断中的应用

Clinical Application of Berman Catheter for Angiographic Diagnosis of Complex Congenital Cardiovascular Anomalies

目的 探讨Berman球囊导管在复杂先天性心血管畸形造影诊断中的应用价值。方法 对 15例经超声心动图诊断为复杂心血管畸形的患者 ,用Berman导管从静脉路径行选择性右心房室、肺动脉造影及导管检查 ,并通过室间隔缺损行左室或主动脉弓降部造影。结果 15例检查均获得技术成功。左室造影能明确显示室间隔缺损相对于半月瓣位置关系 ,并鉴别出 2例完全性大动脉错位。利用Berman导管的漂浮特性 ,在下腔静脉肝段缺如患者能完成其他导管难以实现的肺动脉造影测压。在肺动脉闭锁合并室间隔缺损的婴幼儿患者 ,导管可自右心送达降主动脉完成顺行球囊阻断造影 ,清晰显示固有肺动脉及粗大体肺侧支的解剖及相互关系。本组无并发症发生。结论 Berman导管在选择性心血管造影诊断中用途广泛 ,操作安全 。

Objective To evaluate the clinical superiority of Berman balloon tipped catheter for the angiographic diagnosis of the complex congenital heart diseases. Methods 15 patients suspected by echo to have double outlet right ventricle (DORV, 10 cases), pulmonary arterial atresia (PAA) with ventricular septal defect (VSD, 2 cases) and total endocardial cushion defect (TECD)with the azygous continuation of inferior vena cava(ACIVC, 3 cases) underwent selective right sided heart angiocardiography or catheterization and left ventriculography or aortography through VSD with the sole use of Berman catheter in venous access. Results All the examinations were technically successful without serious implications.The left ventriculography demonstrated graphically location of VSD raletive to both semilunial valves and differentiated two cases of transposition of great arteries (TGA) out of the DORV group. In the TECD group with ACIVC, pulmonary arteriography or pressure measurement were achived with the catheter's floating nature in contrast to other catheters' difficult approach. In the infant cases of PAA with VSD, antegrade balloon occluded aortography from right side clearly showed inherent pulmonary arteries and aortopulmonary collateral branches without arterial access. Conclusion Berman catheter is a safe and versatile angiocatheter for selective opacification of the heart chamber or vessels especially in infants.