介入造影定位法制作比格犬卵圆孔未闭模型

The establishment of patent foramen ovale model in experimental beagles using interventional angiography puncture localization method

目的介绍一种用于制作比格犬卵圆孔未闭（PFO）模型的介入造影定位穿刺方法。方法15只健康比格犬通过介入造影定位法制作PFO模型。全身麻醉下穿刺右股静脉，在右前斜30°X线投照角度下，于上腔静脉边推对比剂边回撤导管至有房底部作造影，结合改良右心房造影穿刺（Inoue法）定位法作房间隔穿刺，用14F扩张鞘管扩张房间隔，制作犬PFO模型。结果与犬房间隔穿刺相关生理与解剖：静息心率快，左右心房内径小，伴有奇静脉开放，下腔静脉在右心房开15位置高，下腔静脉长轴与其入右心房口处均有明显成角，且与房间隔平面成角大。15只比格犬右股静脉穿刺成功率为100％：14只犬房间隔穿刺成功，且均制成PFO模型，1只犬穿破心包放弃进一步操作，成功率为93．3％（14／15）；PFO模型制成后即刻超声测量显示，PFO大小为2．5～4．1（3．2±0．7）mm。结论介入造影定位法制作比格犬PFO模型，操作简便、安全，成功率高。

Objective To introduce the interventional angiography puncture localizationmethod used for the establishment of patent foramen ovule （PFO） model in experimental beagles. Methods Using interventional angiography puncture localization method PFO model was successfully established in 15 healthy experimental beagles. Under general anesthesia the fight femoral vein was punctured, X- ray exposure was made at 30°of right anterior oblique （RAO） position; along with the injection of contrast the catheter in the superior vena cava was pulled back until its tip was at the bottom of the right atrium, which was followed by atrial angiography. By using modified atrial angiography puncturing （Inoue method） localization method the atrial septum puncture was performed. The puncturing site of atrial septum was dilated with a 14 F sheath, and the PFO model was thus established. Results The physiological and anatomical findings related to the atrial septum puncturing were as follows： increased resting heart rate, small internal diameters of left and fight atrium, accompanying the opening of the azygos vein, high position of inferior vena cava opening at right atrium, obvious angulation between the long axis of inferior vena cava and the orifice of right atrium, enlarged angulation between the long axis of inferior vena cava and the plane of atrial septum. The success rate of fight femoral vein puncturing was 100% in 15 experimental beagles; and the puncturing of atrial septum was successful in 14 experimental beagles and the PFO model was successfully established in these 14 beagles. The pericardium was broken due to puncturing in one beagle, and further manipulation had to be given up. The success rate of modeling was 93.3% （14/15）. Ultrasonograpy performed immediately after PFO model was established showed that the diameter of PFO was 2.5-4.1 mm, with a mean of （3.2±0.7） mm. Conclusion For the establishment of PFO model ill experimental beagles, interventional angiography hwalization method is easy to operale and safe, and its success rate is high.