The Specific operation of cardiovascular angiography

1. Before surgery

Skin should be prepared, iodine allergy test and penicillin skin test. In order to avoid nausea, vomiting and aspiration caused by the contrast agent, fasting for 6 hours before the operation, some tranquilizers, such as barbiturates or diazepam, can be given before the operation. And adults with 1% procaine or 1% lidocaine for local anesthesia. Infants and young children need intravenous or intensive anesthesia combined with 1% procaine local anesthesia.

2. Intraoperative

In the operation, the femoral artery and vein are generally inserted into the cardiac catheter. For children who have difficulty in puncturing, they can also cut the saphenous vein or the expensive vein to introduce the catheter, or cut the subcutaneous artery and puncture the artery. The catheter is sent to the selected site for contrast. When the catheter is in the blood vessel and heart cavity, heparin saline (40mg of heparin in 500ml) should be flushed and dripped into the heart catheter to prevent the catheter from clotting. If the left ventricular system is performed, the catheter should be inserted from the catheter when it is placed in the arterial system. 0.5ml/kg of heparin is used for anticoagulation to prevent thrombosis and embolism. After the angiography is completed, withdraw from the cardiac catheter and press to stop the bleeding at the site to be punctured, and then press and bandage until the bleeding stops. In particular, the arterial puncture should pay attention to hemostasis thoroughly to avoid the formation of hematoma. For incision and cannulation, the vein can be ligated at the distal end of the vessel, and the artery should be sutured with non-invasive vascular sutures, and then the skin incision can be suspected.

3. Postoperative

After returning to the ward, cardiovascular patients should observe changes in heart rate, respiration, blood pressure, and body temperature within the first 4 to 6 hours, and discover changes in heart function, arrhythmia, and adverse reactions of contrast agents in time for timely treatment. Awake patients should be encouraged to drink more fluids, and patients who are not awakened from anesthesia should be given appropriate intravenous fluids to promote the discharge of contrast media to reduce the impact on the kidneys. And it is necessary to observe whether the patient's wound has oozing blood. Patients with femoral vein puncture need to stay in bed for 24 hours, and patients with femoral artery puncture need to stay in bed for 36 hours to avoid the formation of hematoma or dissecting aneurysm at the puncture site prematurely. It can be used to diagnose the following cardiovascular diseases.

4. Right Heart Radiography

Confirm the diagnosis of congenital heart disease before surgery; determine the nature of the heart murmur in order to guide the treatment; those who have symptoms again after heart surgery and need another surgery.

5. Left Heart Radiography

Mitral valve stenosis or insufficiency; aortic valve stenosis or insufficiency; congenital heart disease; primary cardiomyopathy; left ventricular aneurysm, etc.

6. Coronary angiography

Recurrent severe angina pectoris, or angina pectoris after myocardial infarction; reexamination after coronary artery bypass graft; coronary congenital malformations; clinically suspected coronary heart disease, but with atypical symptoms.