連続拡張期注入による冠動脈造影法 : その理論的考察に基づく新注入装置の臨床応用

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During ventricular diastole of the cardiac cycle, coronary blood flow reaches the maximum rate with the relative lack of flow in the forward direction in the aortic root. When a contrast medium is injected into the aortic root during cardiac diastole, it is minimally diluted with blood and selectively reaches the coronary arteries at a higher concentration. On the basis of this principle, Nagata, a co-worker of the author, reported the experimental and clinical studies on coronary arteriography using three successive diastolic injections of a contrast medium in synchronization with the cardiac cycle with the satisfactory results. However, the pump used by Nagata as a phasic injector was a Davol Heart Pump devised primarily for circulatory assist, the maximum output of which is only about 10 ml for 0.4 sec of the injecting time, and it was considerable difficult to secure a proper timing for diastolic injection with a Davol Heart pump. Thus, a recent review of his report revealed that excellent opacification of the coronary artery system was achieved only in the experimental animal with a smaller aortic root or in the clinical case with a smaller aortic root or in the clinical case with considerable bradycardia. Accordingly, the author has devised a new injector, with which a pump output of more than 10 ml and an accurate timing for diastolic injection can be easily attained even during a short period of cardiac diastole in a tachycardiac patient. The newly designed device is composed of a control unit and an injector of ventricular type. The actuator and the tubings have been reformed according to the computation from the theoretical considerations and the actual surveys so that filling and ejection of the pump ventricle may be smoothly carried out.
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連続拡張期注入による冠動脈造影法 : その理論的考察に基づく新注入装置の臨床応用

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