Document Detail

Carbon dioxide in the aortic arch: coronary effects and implications in a swine study.
MedLine Citation:
PMID:  12616418     Owner:  NLM     Status:  MEDLINE    
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.
William C Culp; Thomas R Porter; William C Culp; Brian N Vonk
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2003-03-06
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  26     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2003 Mar-Apr
Date Detail:
Created Date:  2003-06-18     Completed Date:  2003-12-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-35     Citation Subset:  IM    
Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot 556, Little Rock, AR 72205-7199, USA.
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MeSH Terms
Angiography, Digital Subtraction
Aorta, Thoracic / metabolism*
Blood Pressure / drug effects,  physiology
Brachiocephalic Trunk / metabolism
Carbon Dioxide / administration & dosage*,  blood*
Coronary Vessels / metabolism
Diastole / drug effects,  physiology
Heart Rate / drug effects,  physiology
Heart Ventricles / metabolism
Injections, Intra-Arterial
Models, Animal
Models, Cardiovascular
Subclavian Artery / metabolism
Systole / drug effects,  physiology
Time Factors
Ultrasonography, Interventional
Reg. No./Substance:
124-38-9/Carbon Dioxide

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