Retrograde catheterization of left ventricle through mechanical aortic prostheses
M Rigaud1, O Dubourg, R Luwaert
1Department of Cardiology, Hôpital Ambroise-Paré, UER Paris-Ouest, Boulogne sur Seine, France.
European Heart Journal
|July 1, 1987
Summary
Catheterization across mechanical aortic valves can induce significant aortic regurgitation (27%), affecting hemodynamics. However, this retrograde approach did not cause complications in patients with prosthetic valves.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Mechanical aortic valve prostheses are common after aortic valve replacement.
- Assessing the impact of cardiac catheterization on prosthetic valve function is crucial.
Purpose of the Study:
- To evaluate catheter-induced aortic regurgitation in patients with mechanical aortic valve prostheses.
- To determine the hemodynamic effects of retrograde left ventricular catheterization on prosthetic aortic valves.
Main Methods:
- Twenty-three patients with mechanical aortic valves underwent retrograde left ventricular catheterization.
- Ten patients had simultaneous transseptal or direct left ventricular puncture for comparison.
- Hemodynamic parameters and regurgitation fractions were measured before and after catheter crossing.
Main Results:
- Catheter crossing induced significant aortic regurgitation (average 27%) and altered hemodynamics, including increased left ventricular end-diastolic pressure and transvalvular gradients.
- Left ventricular end-diastolic volume increased, but ejection fraction remained unchanged.
- No catheterization-related complications were observed.
Conclusions:
- Retrograde left ventricular catheterization across mechanical aortic valves can induce significant regurgitation and hemodynamic changes.
- Despite induced regurgitation, the procedure appears safe in patients with prosthetic aortic valves.
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