Morgan J M, Gray H H, Gelder C, Miller G A
Cardiac Department, Brompton Hospital, London, England.
Cathet Cardiovasc Diagn. 1989 Feb;16(2):87-90. doi: 10.1002/ccd.1810160203.
If retrograde arterial catheterization of the left ventricle fails because of a stenosed native or tissue valve or is contraindicated because of the presence of a mechanical aortic prosthesis, then alternative routes of access to the left ventricle are either transseptal or direct (transapical) left ventricular puncture. The transseptal approach is contraindicated in the presence of a mechanical mitral valve prosthesis. Under these circumstances we have used direct transapical left ventricular puncture in the treatment of 112 patients and have found this technique to be successful with little associated risk. A major complication occurred in 3% of the patients, but the study provided the required data in 95%, and these figures compare favorably with the reported results of transseptal catheterization.
如果由于自身瓣膜或组织瓣膜狭窄导致左心室逆行动脉插管失败，或者由于存在机械主动脉瓣假体而禁忌进行该操作，那么进入左心室的替代途径是经中隔或直接（经心尖）左心室穿刺。存在机械二尖瓣假体时禁忌采用经中隔入路。在这些情况下，我们采用直接经心尖左心室穿刺治疗了112例患者，发现该技术成功率高且相关风险小。3%的患者发生了主要并发症，但该研究为95%的患者提供了所需数据，这些数据与经中隔导管插入术的报告结果相比很有利。
