Right ventriculography is used to evaluate the function of the right ventricle and diagnose conditions like valvular heart disease and cardiomyopathy. While advances in echocardiography and other non-invasive imaging technology have reduced the need for ventriculography, it still has an important role in the diagnosing certain cardiovascular disorders. Moreover, right ventriculography also provides an entry route for endomyocardial biopsy to obtain cardiac tissue from the right ventricle.
Right ventriculography can be challenging since the catheter needs to: (1) pass through the tricuspid valve; (2) inject a large amount of contrast material at a high injection pressure and (3) avoid touching the chamber to prevent inducing premature ventricular contractions (PVC). Proper positioning with the right catheter is essential to perform the procedure successfully.
A pre-shaped catheter specifically designed for right ventriculography via percutaneous femoral approach was discovered by Dr. Yasushi Nishiya of Toyama Prefectural Central Hospital. The catheter is inserted into the common femoral vein of the leg and advanced into the right atrium via wire cannulation. The wire is removed to return the Nishiya to its original shape and the tip is positioned to turn towards the right ventricle (RV). Because of the unique catheter shape, the tip remains centered in the RV even during contrast injection, minimizing the risk of PVC.
Moreover, the Nishiya catheter can also be used in endomyocardial biopsy (EMB) – the gold standard for diagnosing myocarditis and other non-inflammatory cardiovascular diseases. In EMB, the Nishiya catheter is used like a guiding catheter to smoothly and safely lead a long sheath for the biopsy forceps to reach the optimal biopsy site in the septum.
The Nishiya catheter can be used to easily, safely and accurately access the right ventricle of the heart during right heart catheterization.
References:
1. Nishiya Y, Imamura E, Inoue Y. A new preshaped catheter for right ventriculography with minimal artificial tricuspid regurgitation. Ann Thorac Cardiovasc Surg. 1998 Aug; 4(4):214-6.
2. Nishiya Y, Fujimura M, Toshima M, et.al. A new method for right ventricular endomyocardial biopsy via femoral veins: a novel approach employing right ventriculography catheter (Nishiya type). Heart and Vessels. 1998; 13:306-308
Easy-to-use operation with minimal catheter whipping
Reduced friction resistance from the hydrophilic coating
High pressure resistant body with 1200psi
Large catheter lumen of 0.047" (1.19mm) at 5Fr
Maximum flow rate of 19ml/sec
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