Maneuver của vòng lặp từ tâm nhĩ phải để tâm thất phải. Vòng lặp chỉ đạo medially với đầu ống thông chống lại bộ máy ba lá (vị trí), thu hồi nhẹ cẩn thận của ống thông gần cho phép vòng lặp để mở một chút và thả vào tâm thất phải (vị trí b). | CHAPTER 5 Catheter manipulations Figure Maneuver of loop from right atrium to right ventricle. Loop directed medially with tip of catheter against tricuspid apparatus position a careful slight withdrawal of proximal catheter allows loop to open slightly and drop into the right ventricle position b . If none of these maneuvers facilitates entrance into the right ventricle and after no more than two or three attempts the most reliable means of advancing a catheter from the right atrium to the right ventricle is with the use of a deflector wire as described in the next chapter Chapter 6 . When there is a large dilated right atrium or ventricle or when the catheter is relatively straight to begin with experienced operators often resort to one of the deflector-wire techniques as the very first alternative in order to accomplish an expedient entrance into the right ventricle before attempting any flailing around in alarge rig htatrium. Right ventricleto pulmonary artery After maneuvering the 180 loop into the right ventricle the next step of turning the tip of the catheter cephalad and maneuvering a catheter from the right ventricle into the puhnona ry artery is often a very significant drailenge Ị a rticuhtrbrntvlien sUe sip oOthecathaSeo has became stteightot dSSotthe etsOe right atrium aasVor thurthhc ventrido alro molaii thiemanaueer more eifflcuh. Maneuveriag into tho pa a artery ischhelde ablymooa alrsighsSarmerdweanthecsrhetsa Soo asiamsd eomo oa rhe sartrese or iSt shaft tnd a ms dllio rigOt-anglacaoyaet stsasotaiend. Figure Straightening the 180 loop in RV. Position of tip of catheter in RV after rotating 180 loop into ventricle position a straightening of catheter across RV by withdrawing shaft of catheter position b . When the catheter does enter the right ventricle particularly from the femoral approach and after rotating a 180 loop from the right atrium into the ventricle the tip of the catheter is usually directed caudally and .
