Retrograde catheterization of left ventricle through mechanical aortic prostheses
| Autor: | Olivier Dubourg, Jean-Pierre Bourdarias, J. Bardet, M. Rigaud, Rocha P, R. Luwaert, V. Hamoir |
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| Rok vydání: | 1987 |
| Předmět: |
Aortic valve
Male Reoperation medicine.medical_specialty Cardiac Catheterization medicine.medical_treatment Aortic Valve Insufficiency Afterload Aortic valve replacement Risk Factors Mitral valve Internal medicine Coronary Circulation Medicine Humans Postoperative Care business.industry Mitral valve replacement Hemodynamics Mechanical Aortic Valve Middle Aged medicine.disease medicine.anatomical_structure Anesthesia Aortic Valve Heart Valve Prosthesis cardiovascular system Ventricular pressure Aortic pressure Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European heart journal. 8(7) |
| ISSN: | 0195-668X |
| Popis: | Twenty-three patients who had undergone aortic valve replacement with a mechanical aortic valve prosthesis (ball-valve: 17, tilting-disc: 6) were investigated by retrograde left ventricular catheterization using a 6 F pigtail catheter. Twelve of these 23 patients also had had combined aortic and mitral valve replacement. To assess the magnitude of the catheter-induced aortic regurgitation and its effect on left ventricular and mitral valve function, 10 patients (group 1) were simultaneously investigated by the transseptal route (8 patients) or direct left ventricular puncture. The 13 other patients (group 2) were studied only by the retrograde crossing of the aortic valve prosthesis. In group 1, placement of the catheter across the valve induced an increase in heart rate (+12%), in left ventricular end-diastolic pressure (from 17.2 +/- 9.6 to 33.3 +/- 12.0 mmHg), a decrease in aortic systolic (-19%) and diastolic (-25%) pressures, and left ventricular systolic pressure (-10%). Transvalvular aortic pressure gradient increased from 15.4 +/- 8.2 to 23 +/- 12.1 mmHg. Pre- and post-crossing pressure gradients were linearly correlated (r = 0.93). Left ventricular end-diastolic volume increased slightly but significantly (+9%), ejection fraction remained unchanged. Pre- and post-crossing regurgitation fractions were linearly related (r = 0.98). Hence, the magnitude of catheter-induced aortic regurgitation averaged 27% whether or not a pre-crossing regurgitation was noted. In group 2, retrograde crossing of the aortic valve prosthesis induced similar hemodynamic changes. There were no catheterization-related complications.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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