4. • 1964- Ronald Bradley
• First person to describe the use of a
pulmonary-artery catheter in man
• Miniature catheter [extremely narrow portex
catheter (0·63 mm diam)] having no balloon
5. • 1970- Jeremy Swan &
William Ganz
• Balloon floatation catheter
• Balloon tip was a
modification of the simple
portex tubing method
developed by Bradley
7. Diagnostic Indications
• Routine preop evaluation of VSD, ASD, TOF, CoA,
other complex CHD
• High flow or low flow physiology associated with
semilunar valves- Combined AS/AR, combined
PS/PR
• To measure transvalvular pressure difference in
PS, MS, AS
• BDG Cath prior to Fontan
• EP study
• Angiography
11. • TIP: Neither blunt nor too sharp, soft &
flexible.
• Bullet nose tip- least trauma, Though too
taper increased tip penetration.
• HUB: Metal or plastic, larger than catheter,
tapered hubs – easier insertion of guidewire.
TIP & HUB
12. • Rt heart catheters- 100 to 125 cm.
• Lt heart catheters- 100 to 110 cm.
• 125 cm for very tall person.
LENGTH
13. General purpose catheters
• Cournand
• Lehman
• Goodale-Lubin
• Multipurpose Catheter
• Balloon flotation catheters- Swan Ganz
15. Cournand Catheter
• Designed by- Andre Cournand
• End hole radiopaque woven dacron catheter
with outer coating of polyurethrane & nylon
braiding
• Construction- Very gradual distal curve tapered
tip
• Use- All purpose right heart catheter & wedge
pressure recording
• Size- 5 to 8 F, Length- 100 & 125cm
• Disadv- needs frequent flushing, especially in
those with thrombotic tendency like cyanotic
CHD
16. Side Holes
ADVANTAGES
• Prevent catheter damping
[occlusion of coronary
ostium]
• Allow additional blood flow
out of tip, to perfuse artery
• Avoid catastrophic
dissections in the ostium of
artery
• Avoid disengagement
during injections
DISADVANTAGES
• False sense of security
becoz now aortic pressures
& not the coronary pressure
is being monitored
• Suboptimal opacification
• Makes catheter weak-
kinking at side holes
17. Goodale-Lubin Catheter
• Birdseye catheter
• Construction- Woven dacron coated with
polyurethane with nylon braiding
• Hole- Two laterally opposed oval shaped
sidehole near the endhole
• Use- Right heart pressure measurements,
Oxymetry Sampling
• Size- 4 to 8 F; length-80, 100 & 125 cm
19. Multipurpose Catheter
• Designer: Dr. Fred W Schoomaker & King
• Relatively stiff, Single curve with straight tip
• Construction: Polyurethane with an inner
wire braid
• Use-
– Right heart catheterization
– probing atrial septum,
– pressure measurements,
– Angiogram- RCA bypass graft, high LM take
off
– for crossing different lesions PDA & MAPCA
coiling
• Size- 5 & 6 F; length- 80-100 cm
20.
21. Balloon Floatation Catheter- Swan Ganz
• Available with 2-3 lumens
• Balloon tipped-floats through the right side of the
heart safely & easily
• Construction- Balloon- Latex; Shaft-PVC
– (a) Two lumen- Distal port for pressure monitoring &
one lumen for balloon
– (b) Three lumen- additional proximal port for RAP
monitoring
• Size- 5 to 7 F, Catheter length markings at every
10 cm, length-50-110 cm
24. Uses
• Wedge pressure measurement
• Occlusion Angiogram in CS prior to CRT
• To cross mitral valve in BMV
• To cross RSOV
• To cross PA in case of PS
26. Pigtail Catheter
• Designer: Judkins
• Construction: Polyurethane or polyethylene with a
tapered tip, terminal 5 cm of which is coiled back on
itself in a tight loop with 3-6 pairs of side holes on shaft
• Use- LV, RV angiography, aortography & pulmonary
angiography
• Size- 4 to 7 F; Length-65, 80, 100 & 110cm, side holes-
6, 8 or 12
27. Pig tail Catheter
• The end hole permits insertion of a guide wire and hence
can negotiate through tortious vessels and stenotic valves.
• The loop shape keeps the end hole away from the
myocardium.
• Multiple side holes over several centimeters on the shaft
provides stability to the catheter preventing recoil.
• Advantages : excellent contrast delivery , Atraumatic
design, No endocardial staining, Less chance of VPCs , An
end-hole catheter may be used for pressure monitoring
28. TYPES OF PIG TAIL CATHETER
Quanticor (Cardiomarker pigtail )
Pigtail Angiographic
Van Tassel angled pigtail
Grollman PA
Elliptical or Oval
Tennis Racquet
29.
30. CARDIOMARKER PIG TAIL
This is a standard pigtail with radiopaque markers set
2 cm apart.
These act to calibrate distance for quantitative
angiography.
Exact LV distances, volumes and stroke volume can
then be calculated using these markers as a “ruler.”
31. VAN TASSEL ANGLED PIGTAIL
• 8 Non-laterally opposed side hole near the end hole.
• Has a 145˚or 155˚angle that lifts the catheter off the
inferior LV wall for a more centrally located LV gram
• Used for LV gram and aortography.
32. GROLLMAN PA
• It is an angled pigtail catheter with 600 bend and a curve
generally on the reverse side.
• Has 12 non-laterally opposed side hole near the end hole.
• Used for RV & selective PA angiography.
33. • PIGTAIL ANGIOGRAPHIC
The pigtail catheter is the most commonly used LV gram
catheter. With up to 12 side holes it evenly disperses the
contrast within the LV.
• ELLIPTICAL OR OVAL
Designed to pass small aortic valves or vessels with the
curve intact.
• TENNIS RACQUET
The central shaft was designed to reduce the risk of vessel
wall extravasation.
34.
35. NIH Catheter
• It is a side hole catheter without any endhole
• Construction: Made up of woven dacron with nylon reinforcement
& especially stiff. Has 6 round side holes(3 pairs)
• COOK- polyethylene with stainless steel braid, 4 to 6 sideholes
• Polyurethane Cordis NIH cathter & Polyethylene Cook NIH Torcon
blue catheter are much softer & less likely to cause dissection or
perforation
• Use- Visualising RV, LV, arterial, pulmonary vasculature
• Size: 4 to 8 F, Length- 50 to 125 cm
37. BALLOON FLOTATION ANGIOGRAPHIC CATHETER-
Berman
• Standard Berman
• Reverse Berman
• Size- 4 to 8F
• Selected French sizes –lengths-50-110cm
• Identification- (Colour coded Injection port)
• Standard Berman-Pink
• Reverse Berman- Blue
38. Berman Angiography Catheter
• Large Lumen- flow rates similar to pigtail catheter
• Balloon tipped-increases the catheter stability
during angiography
• No end hole-can’t measure wedge
• Multiple side holes-holes proximal to balloon
• Uses-
• Measurement of PA pressure
• Right Ventriculography
42. GENSINI CATHETER
• A type of straight tip catheter.
• Has 3 pairs of side holes and an end
hole.
• Used for left and right angiographic
studies.
• Recoils at high pressure rates and is
more arrhythmogenic and causes
more staining.
43. LEHMAN CATHETER
• The lehman ventriculagraphy
catheter has a multiple side holes
and a tapered closed tip.
• The tapered tip helps in negotiating
tortous vessels and in crossing
stenosis aortic valves.
• The long tip reduces the
chances of endocardial staining.
Editor's Notes
proved that right heart catheterisation is possible in humans
It has an end hole & no side holes- hence suitable for wedge pressure measurements
