pulmonary artery catheterization

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Pulmonary Artery CatheterizationDr. Md.Toufiqur Rahman MBBS, FCPS, MD, FACC, FESC, FRCPE, FSCAI, FAPSC, FAPSIC, FAHA, FCCP, FRCPGAssociate Professor of CardiologyNational Institute of Cardiovascular Diseases(NICVD),Sher-e-Bangla Nagar, Dhaka-1207Consultant, Medinova, Malibagh branchHonorary Consultant, Apollo Hospitals, Dhaka and STS Life Care Centre, Dhanmondi drtoufiq19711@yahoo.com

CRT 2014Washington DC, USA

HistoryFirst Cardiac catheterization According to Andre Cournand, it was first performed by Claude Bernard in 1844, in a horse, both rt and lt ventrilces were entered by retrograde approach from the jugular vein and carotid arteryWerner Forssmann is credited with performing the first cardiac catheterization of a living person himself, at the age of 25 yrsForssmann for his contribution and foresight shared the Nobel Prize in Medicine with Andre Cournand and Dickinson Richards in 1956History1929- Dr. Warner Forssman proven that right heart catheterization is possible in humans1964- Dr. Bradley introduced small diagnostic catheter1970- Balloon Flotation Catheter by Doctor H.J.C Swan and William Ganz

Technique for vascular access:The true Seldinger technique is not used for percutaneous puncture into vessels.

Vascular SheathPercutaneous introduction and then the use of an indwelling vascular sheath in vessels is the standard technique for catheterization of pediatric and congenital heart patients. Ideal sheath should have:Dilator long, fine and smoothly tapered tip. inner lumen of the dilator tip should tightly fit over the guide wire tip of the dilator should have a smooth, fine transitional taper onto the surface of the wire. female Lure lock connecting hub at the proximal end back-bleed valveLateral tube / flush port

Vascular Sheath

When introduced from the inguinal area, the sheath should be long enough to extend into the common iliac vein.

In small infants a sheath into the femoral vein should extend proximal to the formation of the inferior vena cava.

8Vascular SheathIdeal short sheath (7.5 cm long) for venous site 5 Fr for an infant or child (

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