Erschienen in:
01.04.2003 | Clinical Investigations
Carbon Dioxide in the Aortic Arch: Coronary Effects and
Implications in a Swine Study
verfasst von:
William C. Culp, Thomas R. Porter, William C. Culp Jr., Brian N. Vonk
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 2/2003
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Abstract
Purpose: CO2 angiography is
considered dangerous in the aortic arch where bubbles may cause
critical cerebral and cardiac ischemia. We investigated CO2
distribution, physiologic effects in the heart, methods of detection
and treatments.
Methods: Eight pigs had CO2
and iodinated contrast arch angiograms in supine and both lateral
decubitus positions. An electrocardiogram, physiologic data and cardiac
ultrasound were obtained. Therapies included precordial thumps and
rolls to lateral decubitus positions.
Results: Supine
high descending aorta CO2 injections floated retrograde up
the arch during diastole and preferentially filled the right coronary
artery (RCA): mean score 3.5 (of 4), innominate artery 2.4, left
coronary artery 1.2; n = 17; p = 0.0001. Aortic
root injections preferentially filled the RCA when the animal was
supine, left coronary in the right decubitus position, and showed a
diffuse pattern in the left decubitus position. Right decubitus rolls
filled both coronaries causing several lethal arrhythmias. Precordial
thumps successfully cleared CO2. Ultrasound is a sensitive
detector of myocardial CO2.
Conclusion: Arch
distribution of CO2 primarily involves the RCA. Diagnostic
ultrasound detects cardiac CO2 well. Precordial thumps are
an effective treatment.