Karsh D L, Michaelson S P, Langou R A, Cohen L S, Wolfson S
Am J Cardiol. 1978 May 1;41(5):893-6. doi: 10.1016/0002-9149(78)90730-0.
Twenty-seven consecutive patients with an aortic valve prosthesis were evaluated with retrograde left ventricular catheterization. The prosthesis was successfully crossed, permitting hemodynamic and angiographic evaluation of function of the prosthetic valve, left ventricle and mitral valve in all 27 cases. No complications were encountered. In patients with active endocarditis or recent embolization, the retrograde technique was avoided when possible, and attempts were made to utilize other techniques for study. However, three such patients were evaluated with the retrograde technique without complication. Examination of pressure tracings and cineangiographic films suggested only minor interference with valve poppet movement induced by the catheter transversing the valve. In three cases, hemodynamic data were recorded with the catheter crossing the prosthesis at one time and a paraprosthetic valve defect at another time. Identical gradients were recorded. This series documents the safety and efficacy of the retrograde approach, which is proposed as an alternative to the transseptal technique and left ventricular puncture.
对连续27例主动脉瓣置换患者进行了逆行左心室导管检查。在所有27例患者中，导管均成功穿过人工瓣膜，从而能够对人工瓣膜、左心室和二尖瓣的功能进行血流动力学和血管造影评估。未出现并发症。对于患有活动性心内膜炎或近期有栓塞的患者，尽可能避免采用逆行技术，并尝试使用其他技术进行研究。然而，有3例此类患者接受了逆行技术评估，未出现并发症。对压力曲线和电影血管造影胶片的检查表明，导管穿过瓣膜对瓣膜瓣叶运动的干扰很小。在3例患者中，分别在导管穿过人工瓣膜一次和穿过人工瓣膜旁缺损一次时记录了血流动力学数据。记录到相同的压力阶差。本系列研究证明了逆行方法的安全性和有效性，建议将其作为经房间隔技术和左心室穿刺的替代方法。
