左心导管

定义

左心导管 is the passage of a thin flexible tube (catheter) into the left side of the heart. It is done to diagnose or treat certain heart problems.

选择的名字

导尿-左心

如何执行测试

You may be given a mild medicine (sedative) before the procedure starts. 这药是帮你放松的. The health care provider will place an IV into your arm to give medicines. 你将躺在一张有衬垫的桌子上. Your doctor will make a small puncture on your body near one of your arteries. A flexible tube (catheter) is inserted into and through the artery. It will be placed in your wrist, arm or your upper leg (groin). You will most likely be awake during the procedure.

Live x-ray pictures are used to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be injected into your body. This dye will highlight blood flow through the arteries. This helps show blockages in the blood vessels that lead to your heart.

The catheter is then moved through the aortic valve into the left side of your heart. The pressure is measured in the heart in this position. Other procedures can also be done at this time, such as:

• 脑室造影术 to check the heart's pumping function.
• 冠状动脉造影 看看冠状动脉.
• 血管成形术, with or without stenting, to correct blockages in the arteries is then performed.

The procedure may last from less than 1 hour to several hours.

如何准备考试

In most cases, you should not eat or drink for 8 hours before the test. (Your provider may give you different directions.)

The procedure will take place in the hospital. You may be admitted the night before the test, but it is more common to come to the hospital the morning of the procedure. 在某些情况下, this procedure is done after you have already been admitted to the hospital possibly on an emergency basis.

Your provider will explain the procedure and its risks. 你必须签一份同意书.

考试的感觉如何

The sedative will help you relax before the procedure. However, you will be awake and able to follow instructions during the test.

You will be given local numbing medicine (anesthesia) before the catheter is inserted. You will feel some pressure as the catheter is inserted. However, you should not feel any pain. You may have some discomfort from lying still for a long period of time.

为什么要进行测试

The procedure is done to look for:

• 心脏瓣膜病
• 心脏肿瘤
• 心脏缺陷(如 室间隔缺损)
• 心脏功能问题

The procedure may also be done to evaluate and possibly repair certain types of heart defects, 或者打开狭窄的心脏瓣膜.

当这个程序完成后 冠状动脉造影 to examine the arteries that feed the heart muscle, it can open blocked arteries or bypass grafts. This can be because of a heart attack or 心绞痛.

The procedure can also be used to:

• Collect blood samples from the heart
• Determine pressure and blood flow in the heart's chambers
• Take x-ray pictures of the left ventricle (main pumping chamber) of the heart (ventriculography)

正常的结果

A normal result means the heart is normal in:

• 大小
• 运动
• 厚度
• 压力

The normal result also means arteries are normal.

异常结果意味着什么

Abnormal results may be a sign of cardiac disease or heart defects, including:

• 主动脉瓣闭锁不全
• 主动脉瓣狭窄
• 冠状动脉疾病
• 心脏扩大
• 二尖瓣返流
• 二尖瓣狭窄
• 心室 动脉瘤
• 房间隔缺损
• 室间隔缺损
• 心脏衰竭
• 心肌病

风险

并发症可能包括:

• 心脏 心律失常
• 心脏压塞
• 栓塞 from blood clots at the tip of the catheter to the brain or other organs
• 心脏病
• 动脉损伤
• 感染
• Kidney damage from contrast (dye) 
• 低血压
• 对造影剂的反应
• 中风

参考文献

小戈夫DC, lloyd - jones DM, 班尼特克, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. 循环. 2014年,129 (2):S49-S73. PMID: 24222018 pubmed.ncbi.nlm.国家卫生研究院.gov / 24222018 /.

Kern MJ, Seto AH, Hermann J. Invasive hemodynamic diagnosis of cardiac disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 22.

Dengas GD, Mehran R. 冠状动脉造影 and intravascular imaging. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12日艾德. Philadelphia, PA: Elsevier; 2022:chap 21.