Percutaneous fiberoptic angioscopy of the cardiac valves

The feasibility of percutaneous translumial angioscopy of the cardiac valves was examined in eight patients with and in 11 patients without valvular disease. In eight of these patients, a guiding balloon catheter (9F) was introduced into the aortic root, a guide wire (0.014 or 0.025 inch) was introduced through the catheter into the left ventricle to prevent dislocation of the catheter, and a fiberscope (1.6 or 4.6F) was advanced to the distal tip of the catheter. The balloon was then inflated with carbon dioxide and was manipulated against the aortic valve; a body temperature heparinized saline was infused through the catheter for observation. Similarly, the balloon catheter was advanced transseptally into the left atrium for observation of the mitral valve in four patients. Also, the balloon catheter was advanced through the right femoral vein into the right atrium for observation of the tricupid valve in three patients. In patients with a normal aortic valve, the aortic cusp surface was smooth and white and the edges were sharp. They opened briskly during systole and coapted each other completely during diastole. In rheumatic aortic regurgitation, the cuspus were thick and blunt and their coaptation insufficiency was observed during diastole. In a patient with rheumatic AS, globular and yellow cusps were observed. Mitral valve leaflets were smooth and white in a patients without mitral valvular disease, while the leaflets were yellow, thick and irregular, and blood regurgitation from the left ventricle into the left atrium could be observed in two patients with rheumatic MSR. The process of opening and closure of a tricuspid valve was also observed in three patients without tricuspid valvular disease.(ABSTRACT TRUNCATED AT 250 WORDS)