Simmons导管在肺动脉闭锁造影诊断中的临床应用

Clinical Application of Simmons Catheter for the Angiographic Diagnosis of Pulmonary Atresia

目的 介绍一种在肺动脉闭锁患者中选择性显示固有肺动脉结构的临床造影方法。方法 经股动脉插管途径送入Simmons特型导管 ,通过未闭动脉导管或粗大体肺侧支 ,对 2 7例肺动脉闭锁合并室间隔缺损患者行选择性肺动脉造影检查。结果 除 2例婴幼儿患者外 ,采用Simmons导管均清晰显示了中心肺动脉的解剖结构。这种导管能较容易地进入位于主动脉弓不同部位 (特别是发自头臂动脉干 )的未闭动脉导管。在仅存在粗大体肺侧支的 10例患者中 ,笔者成功完成了经体动脉途径的肺动脉楔形造影 ,较传统的肺静脉途径楔形造影更加安全少创。操作过程中未发生血管痉挛或血栓生成等并发症。结论 在肺动脉闭锁合并室间隔缺损的术前检查中 ,利用Simmons导管能够提高诊断质量且便于操作 ,是一种安全有效的方法。

Objective A technique of selective visualization of inherent pulmonary arteries in pulmonary atresia (PA) was described. Methods Selective pulmonary arteriography through the patent ductus arteriosus (PDA) or major aortopulmonary collateral arteries (MAPCAs) with the Simmons catheter inserted from femoral artery were performed in 27 patients with pulmonary atresia and ventricular septal defect (VSD). Results The anatomy of inherent central pulmonary arteries were selectively visualized with the Simmons catheter except in two infant patients. The catheter can easily pass into the PDAs originating from different segments of the aortic arch (especially from the brachiocephalic trunk) within a few minutes. In 10 cases only with MAPCAs, systemic arterial wedge pulmonary arteriography was successfully archived with higher safety and lower stimulus in contrast to conventional pulmonary venous wedge arteriography. No severe complication such as vessel spasm or thrombosis was observed. Conclusion The preoperative assessment of PA and VSD with Simmons catheter is a safe and effective method with respect to diagnostic quality and procedure ease.