Macdonald R G, Feldman R L, Pepine C J
Cathet Cardiovasc Diagn. 1985;11(4):433-9. doi: 10.1002/ccd.1810110414.
Conventional retrograde catheterization of the left ventricle using a single large catheter through severely stenotic aortic valves or prostheses has recognized difficulties. An alternative method is described. This method incorporates a coronary angioplasty guide catheter and coronary probing catheter attached to separate pressure transducers allowing simultaneous recording or aortic and LV pressures. This technique was used in seven patients with aortic stenosis in whom a conventional approach had failed. The movable probing catheter permits alterations of the catheter orientation and angulation while the guiding catheter stabilizes the system within the high velocity jet formed in the ascending aorta. This stabilization and the small size of the coronary probing catheter permit exploration of the valve surface and allow for insertion through a tilting disc valve or a severely stenotic valve without significantly altering hemodynamic function. In our laboratory this technique allowed us safely and reliably to assess aortic valve dynamics in each of the patients in whom the technique was attempted without resorting to either transseptal or direct left ventricular puncture.
使用单个大导管通过严重狭窄的主动脉瓣或人工瓣膜进行左心室传统逆行导管插入术存在公认的困难。本文描述了一种替代方法。该方法采用冠状动脉成形术引导导管和冠状动脉探测导管，它们连接到单独的压力传感器，可同时记录主动脉和左心室压力。该技术用于7例传统方法失败的主动脉瓣狭窄患者。可移动的探测导管允许改变导管方向和角度，而引导导管在升主动脉形成的高速射流中稳定系统。这种稳定以及冠状动脉探测导管的小尺寸允许探查瓣膜表面，并允许通过倾斜盘瓣或严重狭窄瓣膜插入，而不会显著改变血液动力学功能。在我们实验室，该技术使我们能够安全可靠地评估每例尝试该技术的患者的主动脉瓣动力学，而无需采用经中隔或直接左心室穿刺。
