Advices for Life


November 23, 2016 00:03

contrast ventriculography

Contrast ventriculography (SH) - one of the most important angiographic catheterization techniques.Ventriculography - a ventricular opacification with images recorded on film or other recording device (video tape, a computer hard drive or CD-ROM).It is widely used to determine the radiological anatomy and ventricular contractility in patients with valvular heart disease, coronary artery disease, cardiomyopathy.

Left ventriculography

Contrast left ventricular (LV) (left ventriculography) provides information about its scope, general and regional contractility state mitral (regurgitation) of the valve, the presence and location of the septal defect, change the shape and configuration of the cavity at the aneurysm, ischemia ormyocardial hypertrophy.

Right ventriculography

Contrast of the right ventricle (RV) (right ventriculography) also allows you to assess the volume settings of the chambers of the heart, general and local contractility in patients with porokamy heart, and recently it is often mad

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To get an adequate picture ventricle requires about 40 ml of PKB introduced automatic syringe injector for SH-catheter, the tip of which is located in the ventricular cavity, with the introduction of a rate of about 10-16 ml / s.

PKB volume and speed of administration depends on the size (inner lumen) catheter and cavity ventricular hemodynamic status before the HS.If the LV CRT & gt;27-30 mm Hg.Art., should refrain from the IG to reduce it (nitroglycerin, diuretics) to avoid pulmonary edema due hypervolemic additional load associated with the arrival of high-PKB.If necessary, a two projection ventriculography in the right anterior oblique projection angle of 30 ° and left oblique projections - 45-60 °, to evaluate all ventricular segments.More often do odnoproektsionnuyu ventriculography in the right anterior oblique projection.In this case, LV can be seen in its long axis and can estimate perednebazalny, anterolateral segment, top, bottom, and the region segments zadnebazalny mitral valve.If you want to explore the interventricular septum (eg, in patients with post-infarction left ventricular aneurysm front), additionally operate the left oblique projection.

Regional ventricular contractility is quantified at a computer image processing in the percentage shortening of the radius drawn from the center of the ventricle, or quality when viewed frame by frame as a violation of wall motion of systole to diastole.With a decrease in range of motion diagnosed hypokinesia, in the absence of wall motion of systole to diastole - akinesia, with bulging segment in systole-diastole of the contours - dyskinesia.

Thus, in post-infarction left ventricular focal changes are often determined by a and dyskinesia (aneurysm), ischemia of any segment - hypokinesia, with dilated cardiomyopathy - enlarged cavity and diffuse hypokinesia of all segments, with hypertrophic cardiomyopathy, left ventricular cavity contoursoften acquire a particular configuration (in the form of peaks with a pointed tip at the apical form, in the form of a banana or foot ballerina with subaortic stenosis, in the form of an hourglass with srednezheludochkovoy hypertrophic cardiomyopathy).

At the end of the last century with the introduction of digital (digital) angiography with computer image processing, background subtraction masks and increased as a result of the final image an opportunity to enter a 2-fold lower amounts of PKB better tolerated by the patient and less hemodynamic changes.It has become acceptable to visualize the interventricular septum single administration of 20 mL of PKB in the cavity of the right atrium.

Complications ventriculography

  • cardiac arrhythmias - ventricular premature beats single and group often encountered in ventriculography, they cause the inner wall touching the tip of the catheter or ventricular PKB spray when injected into the cavity.Preventive measures: careful location of the catheter into the ventricular cavity, reducing the rate of administration PKB, sometimes have to be administered antiarrhythmic drugs do defibrillation;
  • symptom "endocardial spots" - when used for ventriculography single lumen catheter and the tip of it rests on the wall, perhaps by contrast hit endocardium.Since the catheter is of the "pig-tail" was applied with additional lateral openings complications is practically not occur;
  • thrombus embolism, or air from the catheter as well as a fragment of a blood clot while stationed intraventricular parietal thrombosis.To prevent this, carefully check the connection automatic injector catheter for air bubbles.In the presence of intraventricular thrombus according to echocardiography should try to avoid touching the catheter or abandon the ventriculography;
  • reactions associated with the effect of PKB, - a sense of warmth, nausea, rarely vomiting.Typically, these phenomena are rapidly, and using in the last decades of nonionic PKB became rare.In the event of an allergic reaction are administered antihistamines (diphenhydramine, suprastii et al.), Corticosteroids, adrenaline, conduct infusion therapy.