Kosmicki Douglas, Michaels Andrew D
Division of Interventional Cardiology, University of Utah, Salt Lake City, UT, USA.
Catheter Cardiovasc Interv. 2008 Feb 15;71(3):429-33. doi: 10.1002/ccd.21374.
Patients with rheumatic heart disease and a history of mechanical aortic valve replacement will occasionally present with significant mitral stenosis for consideration of mitral balloon valvuloplasty. The conventional retrograde trans-aortic method for left heart catheterization cannot be done for patients with a mechanical aortic valve. We present a patient with a mechanical aortic valve who underwent successful left heart catheterization and mitral valvuloplasty via a transseptal approach. A 5 French pigtail catheter was advanced through the left atrial 8 French Mullins sheath into the left ventricle, for simultaneous pressure measurement across the mitral valve. This manuscript discusses the strengths and weaknesses of several approaches for left heart catheterization in patients with a mechanical aortic valve.
患有风湿性心脏病且有机械主动脉瓣置换史的患者偶尔会出现严重二尖瓣狭窄，需要考虑进行二尖瓣球囊瓣膜成形术。对于安装了机械主动脉瓣的患者，无法采用传统的经主动脉逆行法进行左心导管插入术。我们报告了一例安装机械主动脉瓣的患者，其通过经房间隔途径成功进行了左心导管插入术和二尖瓣瓣膜成形术。一根5法国猪尾导管通过左心房8法国穆林斯鞘管推进至左心室，用于同步测量二尖瓣两侧的压力。本文讨论了几种针对安装机械主动脉瓣患者的左心导管插入术方法的优缺点。
