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A new umbilical vein catheter
JOURNAL
OF SURGICAL
RESEACH
17,
269-270
(1971)
PRELIMINARY A New RICHARD
E.
KESSLER, AND
REPORT
Umbilical M.D.,
Vein Catheter
F.A.C.S.,
DAVID
S.
ZIMMON,
IN ORDER TO FULLY UTILIZE the diagnostic, therapeut’ic, and research potential of umbilical vein catheterization, we have designed a special catheter. Any large-caliber soft polyethelene catheter is suitable to measure portal pressure, sample portal venous blood, and obtain portohepatograms. However, catheter modifications are required for extracurporcal umbilicosaphenous shunting to control bleeding csophageal varices, remove schistosomes by hemofiltration, or to evaluate the hemodynamic response to portal venous diverFlom the Departments of Surgery and Mcdicinr, New York University School of Medicine, and Manhattan Veterans Administration Hospital, Kew York, New York 10010. Submitted for publication March 28, 1974.
DAVID
A.
TICE,
M.D.,
F.A.C.S..
M.D.
sion in patients with portal hypertension [Il. Figures 1 and 2 illustrate the doublelumen cannula made of polyvinyl chloride and available in sizes 12-22 French (USC1 Special Order). Sizes 14, 16, and 18 are the calibers most frequently used. The largest lumen has an internal diameter varying from .091 inches to .192 inches. The second lumen attached to 4/S of the basic catheter length (35 cm) has an internal diameter of .035 inches. This has a Lucr-lock adaptor attached at the end to permit’ infusion of heparin dliring extracorporeal diversion of portal venous blood and monitoring of portal venous prwure. The end of the main cat’heter is fcmwl shaped for easy attachment to tubes and adaptors of vari-
l-25
cm.
‘bK+
35 cm.
I-
Fig. 1. Drawing of double-lumen umbilical vein catheter showing dimension.
Fig. 8. Photograph of umbilical vein catheter.
269 Copyright All
rinhts
0 1974 by Academic of renrod~~ction in anv
Press, fnc. form T~C.WJ
-I
270
JOURNAL
OF SURGICAL
RESEARCH,
ous sizes in extracorporeal circuits. The main catheter is reinforced with coiled wire to prevent narrowing of the lumen when the catheter is secured in the falciform ligament and to prevent collapse of the tubirrg at high flow rates (up to 2500 cc per minute) that may be achieved during extracorporeal umbilicosystematic shunting of portal blood. The tip of the catheter that lies in the left branch of the portal vein has been notched to prevent occlusion by the wall of the left portal vein. To further assure unimpeded flow at high flow rates,
VOL.
17,
NO.
4,
OCTOBER
1974
three holes (l-3 mm in diameter) have been placed in the portion of the catheter that lies within t,he left portal vein. This catheter has been used by us in more than 75 patients and is easily adapted to the various procedures that utilize umbilical vein catheterization. REFERENCE 1. Kessler, R. E., Tice, D. A., and Zimmon? D. S. Value, complications and limitations of umbilical vein Surg. Gynecol. catheterization. Obstet. 136:529, 1973.
OF SURGICAL
RESEACH
17,
269-270
(1971)
PRELIMINARY A New RICHARD
E.
KESSLER, AND
REPORT
Umbilical M.D.,
Vein Catheter
F.A.C.S.,
DAVID
S.
ZIMMON,
IN ORDER TO FULLY UTILIZE the diagnostic, therapeut’ic, and research potential of umbilical vein catheterization, we have designed a special catheter. Any large-caliber soft polyethelene catheter is suitable to measure portal pressure, sample portal venous blood, and obtain portohepatograms. However, catheter modifications are required for extracurporcal umbilicosaphenous shunting to control bleeding csophageal varices, remove schistosomes by hemofiltration, or to evaluate the hemodynamic response to portal venous diverFlom the Departments of Surgery and Mcdicinr, New York University School of Medicine, and Manhattan Veterans Administration Hospital, Kew York, New York 10010. Submitted for publication March 28, 1974.
DAVID
A.
TICE,
M.D.,
F.A.C.S..
M.D.
sion in patients with portal hypertension [Il. Figures 1 and 2 illustrate the doublelumen cannula made of polyvinyl chloride and available in sizes 12-22 French (USC1 Special Order). Sizes 14, 16, and 18 are the calibers most frequently used. The largest lumen has an internal diameter varying from .091 inches to .192 inches. The second lumen attached to 4/S of the basic catheter length (35 cm) has an internal diameter of .035 inches. This has a Lucr-lock adaptor attached at the end to permit’ infusion of heparin dliring extracorporeal diversion of portal venous blood and monitoring of portal venous prwure. The end of the main cat’heter is fcmwl shaped for easy attachment to tubes and adaptors of vari-
l-25
cm.
‘bK+
35 cm.
I-
Fig. 1. Drawing of double-lumen umbilical vein catheter showing dimension.
Fig. 8. Photograph of umbilical vein catheter.
269 Copyright All
rinhts
0 1974 by Academic of renrod~~ction in anv
Press, fnc. form T~C.WJ
-I
270
JOURNAL
OF SURGICAL
RESEARCH,
ous sizes in extracorporeal circuits. The main catheter is reinforced with coiled wire to prevent narrowing of the lumen when the catheter is secured in the falciform ligament and to prevent collapse of the tubirrg at high flow rates (up to 2500 cc per minute) that may be achieved during extracorporeal umbilicosystematic shunting of portal blood. The tip of the catheter that lies in the left branch of the portal vein has been notched to prevent occlusion by the wall of the left portal vein. To further assure unimpeded flow at high flow rates,
VOL.
17,
NO.
4,
OCTOBER
1974
three holes (l-3 mm in diameter) have been placed in the portion of the catheter that lies within t,he left portal vein. This catheter has been used by us in more than 75 patients and is easily adapted to the various procedures that utilize umbilical vein catheterization. REFERENCE 1. Kessler, R. E., Tice, D. A., and Zimmon? D. S. Value, complications and limitations of umbilical vein Surg. Gynecol. catheterization. Obstet. 136:529, 1973.