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Percutaneous left ventricular angiography

C M Wong, P H Wong, G A Miller

    Catheterization and Cardiovascular Diagnosis
    |January 1, 1981
    PubMed
    Summary
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    Transapical left ventriculography offers a vital diagnostic method for heart failure patients post-valve replacement when other tests fail. This technique aids in distinguishing poor heart function from other issues, guiding surgical decisions.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Cardiac Surgery

    Background:

    • Diagnosing persistent heart failure after mitral and aortic valve replacement is challenging.
    • Noninvasive tests and standard cardiac catheterization may not differentiate poor left ventricular function from paraprosthetic leak or pulmonary vascular disease.
    • Left ventricular inaccessibility complicates diagnostic evaluations.

    Purpose of the Study:

    • To evaluate the utility of transapical left ventriculography in diagnosing heart failure post-valve replacement.
    • To assess the safety and efficacy of percutaneous transapical flexible angiographic catheter passage in this patient group.

    Main Methods:

    • Left ventriculography was performed via direct transapical puncture using a flexible angiographic catheter.

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  • The procedure was conducted in 15 patients (16 occasions) with suspected persistent heart failure after valve replacement.
  • Clinical decisions were made based on the diagnostic information obtained.

    • Main Results:

    • Transapical left ventriculography provided crucial diagnostic information in challenging cases.
    • Non-fatal complications occurred in three patients.
    • The procedure successfully distinguished operable from inoperable patients, enabling appropriate clinical management.

    Conclusions:

    • Percutaneous transapical left ventriculography is a valuable alternative diagnostic tool when standard methods are insufficient.
    • This technique aids in guiding surgical decisions for patients with persistent heart failure after valve replacement.
    • The procedure demonstrated a favorable risk-benefit profile in this cohort.