What Is a Surgical Catheter?

Cardiac catheterization is a technique of inserting a catheter from the surrounding blood vessels and sending it to the heart cavity and large blood vessels to obtain information for inspection and diagnosis purposes, as well as certain treatment measures.

Cardiac catheterization

Cardiac catheterization is a technique of inserting a catheter from the surrounding blood vessels and sending it to the heart cavity and large blood vessels to obtain information for inspection and diagnosis purposes, as well as certain treatment measures.

Chinese name

Cardiac catheterization

Also called "cardiac catheterization", the catheter can be sent to the right part of the heart and the pulmonary artery, or to the left part of the heart and the aorta. It can also be injected with contrast agent through the catheter or clinical electrophysiological examination.

Right heart catheter examination: insert the catheter from the surrounding veins and send it to the superior and inferior vena cava, right atrium, right ventricle and pulmonary artery, etc. During the intubation process, you can observe the path of the catheter to clarify the heart cavity and large blood vessels If there is a malformed channel between them, record the pressure curve of each part separately, take blood samples of each part, measure its blood oxygen content, calculate the cardiac output and hemodynamic index.

Left heart catheter examination: send the catheter to the pulmonary vein, left atrium, left ventricle and aorta, observe the path of the catheter, record the pressure curve of each part, take blood samples from each part, measure its blood oxygen content, and calculate cardiac drainage Volume and hemodynamic indicators. There are a variety of methods for left heart catheter examination. The right heart catheter can be used to enter the pulmonary vein and left atrium through malformed pathways, or the right heart catheter can be used to enter the left atrium through atrial septum. The more commonly used method is from peripheral arteries (such as the femoral Arteries, brachial arteries) were retrogradely cannulated and delivered to the aorta and left ventricle.

When it comes to cardiac catheterization, people will think of its inventor, the famous German surgeon Werner Forsman, who was only 25 years old when he invented cardiac catheterization. It was in 1929 that Forsman worked as an assistant surgeon at Eberswalde Auguste-Victoria Hospital. One day, he suddenly had a whimsy: traditional cardiac examination methods, such as auscultation, X-ray fluoroscopy, electrocardiography, etc., are not enough for diagnosis and indications in cardiac surgery, and he urgently needs to invent a method that touches the heart. Internal methods for measuring pressure, taking blood directly, checking oxygen and carbon dioxide levels, using fast-acting drugs for life-threatening patients, and using X-ray contrast agents to detect the heart's anatomy and blood flow.

Soon, Fosman came up with a bold idea: a thin, flexible hose that led from the elbow to the heart. The health committee member responsible for the management of the hospital was a friend of Fosman's parents. He was frightened by Fosman's bold idea. He believed that the law was "blasphemous", because heart surgery was prohibited at the time. He even disagreed with Fu. Siman did this experiment with his own body. So Fosman had to act secretly. Upon repeated requests by Forsman, his friend and colleague Romès performed a venipuncture of his elbow, and then applied a sterile thick olive-shaped soft catheter with sterilized olive oil and carefully blessed the hose. Sman's heart advanced. When the catheter was pushed to the clavicle, Fosman was irritated. He coughed, and Rommes disregarded Fosman's blocking and immediately withdrew the catheter outside the body. The first experiment failed.

A week later, Forsman experimented again. He cut the anterior elbow vein under his left elbow fossa under local anesthesia, inserted the catheter into the vein, and advanced forward along the vein. Then he observed it with a mirror in front of the X-ray fluorescent screen around him, and finally pushed the catheter. He also took an X-ray picture of his right atrium. Throughout the experiment, he didn't feel any pain, only a warm feeling, just like the feeling after the calcium injection.

Since then, Fosman has performed nine similar experiments on himself, exhausting all surrounding superficial veins, and injecting a concentrated sodium iodide solution into the catheter, taking very light right heart angiograms.

Later, Forsman wrote a paper entitled "Right Heart Catheter Examination", reporting on his cardiac catheterization and its role in diagnosis and treatment. Unfortunately, this cardiac catheterization was not valued and supported by the medical profession in Germany at the time, and he was once forced to abandon the research project and transfer to urology. Until 1941, American medical scientists Kunnand and Richards were interested in Forsman's cardiac catheterization. They improved and applied this technology to the research of hemodynamics and circulation breathing physiology, and will obtain many achievements. Make it public. Since then, Forsman's cardiac catheterization has aroused widespread interest and attention in the medical community. By 1945, they had accumulated 1,200 experience in cardiac catheterization, which opened the way for cardiac surgery. Since the 1950s, Forsman's cardiac catheterization has become more widely used in clinical practice and is becoming more and more mature. It can help measure the pressure and oxygen content of blood in the heart and various parts of the blood vessels. Studying the metabolic functions of the heart, liver, and kidney has great clinical value; the development of cardiac surgery is increasingly showing its extraordinary credit.

Forsman invented cardiac catheterization and bravely performed experiments on himself, proving that it is harmless to the human body, but can diagnose heart disease. The first one opened a new path for studying pathological changes in the circulatory system; The two Richards medical scientists attached great importance to improving Forsman's cardiac catheterization and made important achievements. To this end, the three of them were jointly awarded the Nobel Prize in Medicine in 1956.

include:

Diagnose and observe rejection after heart transplantation and guide treatment.

Diagnose myocardial inflammation, observe and guide treatment.

Assist in the diagnosis of certain primary cardiomyopathy, such as hypertrophic, congestive cardiomyopathy, Keshan disease, etc.

Confirm the diagnosis of some secondary cardiomyopathy, such as sarcoidosis, amyloidosis, hemochromatosis, glycogen storage disease, etc.

Assisted diagnosis of myocardial disease caused by radiation therapy and adriamycin (anticancer drug) treatment.

Diagnosis of endocardial fibrosis.

Identify restricted cardiomyopathy and constrictive pericarditis. Because the clinical manifestations of the above-mentioned various endocardium and myocardial diseases resemble constrictive pericarditis, endocardial biopsy can be used for differential diagnosis.

In addition, myocardial biopsy is used for special research in the biochemistry and immunology of the myocardium, which can also help elucidate the cause of certain heart diseases.