希氏束电极指导下犬房间隔穿刺术  

Transseptal puncture guided by His bundle electrical catheter in canines

作　　者：丁立刚[1] 华伟[1] 蔡迟[1] 江勇[1] 姚焰[1] 张澍[1] 

机构地区：[1]阜外心血管病医院,北京100037

出　　处：《岭南心血管病杂志》2015年第3期412-414,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的 探讨希氏束电极指导下犬房间隔穿刺术方法的安全性和有效性。方法 选取9只健康杂种犬,正位下标测电极定位希氏束,穿刺针鞘由上腔静脉回撤过程中“弹跳”征初步定位卵圆窝,再以希氏束下1/2~3/4肋间再次定位卵圆窝。穿刺方向为穿刺针远端弧度最大展开穿刺房间隔,在导丝保护下送外鞘入左心房。结果 9只杂交犬房间隔穿刺全部成功,8（89%）只犬一针穿刺成功,穿刺总时间（3.2±0.4）min,曝光时间（1.7±0.3）min。1例术中无症状,术后解剖时发现心包有少量渗血。结论 正位下希氏束电极指导犬房间隔穿刺术是简单、易行的犬房间隔穿刺方法。Objectives To investigate the safety and efficacy of transseptal puncture guided by His bundle electrical catheter in canines. Methods Transseptal puncture had been carried out in 9 healthy canines guided by His bundle electrical catheter. His bundle potential was mapped by catheter as a mark in anteroposterior（AP） view firstly. The dilator-sheath assembly was then withdrawn smoothly from the superior vena cava（SVC） towards the canine ＇s feet while observing the ‘jump sign ＇ of the catheter on X-rays. The fossa ovalis was relocated by His bundle electrical catheter in AP view as another landmark of fossa ovalis. The needle was pushed when the needle and the sheath were rotated simultaneously until the distal curve of their images maximized. Finally, the sheath was advanced into the left atrium under the protection of guidewire. Results Guided by His bundle electrical catheter, the success rate of transseptal puncture was 100%（9 / 9）, the single-puncture success rate was 89%（8 / 9）, the total procedure duration was（3.2±0.4） min, and the exposure duration was（1.7±0.3） min. Tamponade developed in one dog without clinical outcomes. Conclusions Transseptal puncture guided by His bundle electrical catheter can be performed easily in canines.

关 键 词：房间隔穿刺 希氏束 犬 

分 类 号：R33[医药卫生—人体生理学]