New technique for retrograde left heart catheterization in aortic stenosis

• Published in: Catheterization and cardiovascular diagnosis Vol. 8; no. 3; p. 299
• Main Authors: Baur, H R, Mruz, G L, Erickson, D L, VanTassel, R L
• Format: Journal Article
• Language: English
• Published: United States 1982
• Subjects: Adult; Aged; Aortic Valve Stenosis - diagnostic imaging; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Coronary Angiography; Female; Humans; Male; Middle Aged
• ISSN: 0098-6569
• DOI: 10.1002/ccd.1810080315

Retrograde catheterization of the left ventricle in patients with aortic stenosis is frequently difficult and occasionally impossible. We have developed a new technique to facilitate this problem. A standard #8 "pigtail" catheter is preformed with a 145 degrees angle 7 cm from the catheter tip. With this catheter in the ascending aorta, the preformed angle lifts the catheter tip leftward and superiorly, allowing a straight guidewire a direct approach to the orifice of the stenotic aortic valve. Utilizing this technique, we were able to cross the stenotic aortic valve in 26-29 consecutive patients with isolated aortic stenosis (mean gradient +/- 0.22 cm2, mean fluoroscopy time for crossing: 32 +/- 40 seconds). The 145 degree angle also lifts the catheter off the posterior wall of the left ventricle and allows a more parallel alignment of the catheter with the long axis of the left ventricle, leading to a more stable position with less ventricular dysrhythmias during angiography. Thus a preformed angle in the "pigtail" catheter facilitates crossing of the stenotic aortic valve and produces a more stable position in the left ventricle.