Downloaded 96 times
![• 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](https://image.slidesharecdn.com/rightheartcatheters-220220054616/75/Right-heart-catheters-4-2048.jpg)
![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](https://image.slidesharecdn.com/rightheartcatheters-220220054616/75/Right-heart-catheters-16-2048.jpg)
More Related Content
Similar to Right heart catheters
Right heart catheters
- 1. DR. ROHIT WALSE FELLOW INTERVENTIONCARDIOLOGY SCTIMST KERALA Right Heart Catheters
- 2. SCOPE • HISTORY • INDICATIONSOF RHC • GENERAL PURPOSE CATHETERS • ANGIOGRAPHIC CATHETERS
- 3. HISTORY • 1929- WernerForssmann
- 4. • 1964- RonaldBradley • 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- JeremySwan & William Ganz • Balloon floatation catheter • Balloon tip was a modification of the simple portex tubing method developed by Bradley
- 6. INDICATIONS OF RHC •Diagnostic indications • Therapeutic indications
- 7. Diagnostic Indications • Routinepreop 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
- 8. Diagnostic Indications • Oxymetry- •Shunt Quantification • Calculate CO, CI • Calculate PVR, SVR
- 9. Therapeutic Indication • Closureof- ASD, VSD, PDA, MAPCA • PTMC • IVC filter • BAS • BPV
- 10. PARTSOF A CATHETER HUB BODY TIP HUB BODY TIP
- 11. • TIP: Neitherblunt 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 heartcatheters- 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
- 14. Angiographic Catheters • Pigtailangiographic catheter • NIH • Flow directed angiographic catheter(balloon flotation catheter) • Gensini • Lehman Ventriculography • Eppendorf
- 15. Cournand Catheter • Designedby- 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 • Preventcatheter 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 • Birdseyecatheter • 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
- 18.
- 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
- 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
- 23. Approx Balloon inflation •5 F 0.75 ml • 6 F 1 ml • 7 F 1.5 ml
- 24. Uses • Wedge pressuremeasurement • Occlusion Angiogram in CS prior to CRT • To cross mitral valve in BMV • To cross RSOV • To cross PA in case of PS
- 25.
- 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 PIGTAIL CATHETER Quanticor (Cardiomarker pigtail ) Pigtail Angiographic Van Tassel angled pigtail Grollman PA Elliptical or Oval Tennis Racquet
- 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 ANGLEDPIGTAIL • 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 • Itis 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 Thepigtail 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.
- 35. NIH Catheter • Itis 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
- 36.
- 37. BALLOON FLOTATION ANGIOGRAPHICCATHETER- 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
- 40. Reverse Berman Catheter •Multiple side holes distal to the balloon • Use- Pulmonary angiograghy
- 42. GENSINI CATHETER • Atype 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 • Thelehman 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.