What is a Femoral Catheter?

The open arterial catheter is located between the descending aortic isthmus distal to the left subclavian artery and the root of the left pulmonary artery. The shape can be tubular, funnel-shaped, and the short one is window-shaped. Arterial duct patency is one of the most common congenital heart diseases. Congenital cardiovascular disease ranks second. Due to the disparity in pressure between the aorta and the pulmonary artery, the open arterial duct caused continuous left-to-right shunting, which increased the pulmonary circulation and blood flow back to the left atrium, and the left and right ventricular loads increased.

Open arterial catheter

The open arterial catheter is located between the descending aortic isthmus distal to the left subclavian artery and the root of the left pulmonary artery. It is thick, slender, and short, with an outer diameter of about 10 mm and a length of about 6 to 10 mm. The shape can be tubular, funnel-shaped, and the short one is window-shaped. Arterial duct patency is one of the most common congenital heart diseases. Congenital cardiovascular disease ranks second. Due to the disparity in pressure between the aorta and the pulmonary artery, the open arterial duct caused continuous left-to-right shunting, which increased the pulmonary circulation and blood flow back to the left atrium, and the left and right ventricular loads increased.

Chinese name

Open arterial catheter

Clinical manifestation

Pulmonary congestion

Harm

Cold or respiratory infection

Features

Rough continuous machine-like noise

Babies with thick ducts and large shunts are susceptible to colds or respiratory infections due to congested lungs, dysplasia, and even left heart failure. If the catheter is thin and the flow is small, it can be asymptomatic for life.

In the 2nd intercostal space on the left side of the sternum, a loud and continuous continuous machine-like noise is heard, which is transmitted to the left subclavian fossa or neck, which can cause tremors locally; those with obvious pulmonary hypertension can only hear systolic noise. Hypertonic second sound in the pulmonary valve area. In the case of larger shunts, a soft diastolic murmur can also be heard at the apex. Peripheral vascular signs include broadened and enlarged pulse pressure, increased pulsation of the neck blood vessels, arteries of the extremities that can touch the water and pulse, and the sound of gunshots. However, as the pulmonary arterial pressure increases, the shunt volume decreases without significant and disappears.

Those with small ducts with small flow volume are normal or the shaft is skewed to the left. Higher partial flow indicates high left ventricular voltage or left ventricular hypertrophy. Pulmonary arteries are obviously crooked, neon-etched or neon-etched?

The heart shadow increases with the shunt, and the left ventricle margin extends downward and outward. The mediastinal shadows are widened, the aortic nodes are prominent, and they may be funnel-shaped, the pulmonary artery cones are straight or bulged, the hilar vessels are darkened, and the lung texture is thickened.

Left atrium and left ventricle diameter increased. The two-dimensional section can show the arterial catheter that communicates with the main and pulmonary arteries, and its inner diameter and length can be measured; Doppler shows turbulence and can determine the size of the shunt.

Premature babies have a high incidence of open ductus arteriosus, and are prone to cause respiratory distress. You can first take indomethacin treatment to inhibit the synthesis of prostaglandin E and promote catheter contraction and closure; if it does not work, you need surgery. Infants and young children with heart failure should be treated early. The most appropriate age for surgery is 6 to 14 years. Patients with pulmonary hypertension should undergo surgery as soon as possible. Even if the pulmonary artery pressure increases, as long as the shunt is left to right, surgery should be performed to prevent it from developing into a reverse shunt and lose the opportunity for surgery. After adulthood, the arteries gradually harden and become fragile, increasing the risk of surgery. For patients with bacterial endocarditis, it is best to perform surgery 2 months after the infection is controlled by antibiotics.

Tracheal intubation was performed under anesthesia. The patient was placed in the right lateral position, a posterior lateral thoracotomy was performed, and the chest was inserted through the fourth intercostal space. The diagnosis can be confirmed with pulmonary artery dryness and tremor. The mediastinal pleura was cut behind the vagus nerve or between the mediastinal nerve to fully expose the superior descending aorta and the anterior wall of the catheter, and then the loose tissue on the upper and lower edges of the catheter and the dorsal side were separated. If the catheter is short, it is best to free the descending aorta connected to the catheter. Pay attention to protect the recurrent laryngeal nerve. There are two ways to handle the catheter:

It is suitable for infants with slender catheters. The main and pulmonary arterial ends of the open catheter are ligated with thick wires. Pulmonary arterial pressure is higher, and the larger catheter must be ligated under controlled hypotension to avoid tearing the wall of the bleeding or failing to completely close the lumen. Alternatively, a polyester sheet can be placed on the outside of the catheter before ligation.

Open arterial catheterization

Suitable for patients with short and thick catheters. The main and pulmonary sides of the open catheter were clamped with non-invasive forceps, and the two cut ends were sutured while cutting. Adults with significant pulmonary hypertension, especially those suspected of calcification of the arterial wall, it is best to perform a sternal midline incision to block the heart blood circulation under low-temperature extracorporeal circulation. It is safer to close the inside of the arterial catheter through the pulmonary incision suture.

Open arterial catheterization

In recent years, people have percutaneously punctured the femoral artery and femoral vein, inserted catheters to the upper end of the descending aorta and the pulmonary artery, respectively, and introduced thin wires. A plastic stopper is then inserted into the femoral artery (Porstmann method) or femoral vein (Rashkind method), and the top of the cardiac catheter is inserted into the arterial catheter along the wire to block it. This non-thoracic occlusion method has a high success rate for the closure of small catheters.

Open arterial catheter other methods

Thoracoscopic forceps closed catheter for infants.