| Transthoracic left ventricular puncture for the assessment of patients with aortic and mitral valve prostheses: the Massachusetts General Hospital experience, 1989-2000. | |
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MedLine Citation:
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PMID: 12652508 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Accurate assessment of suspected prosthetic valve dysfunction is critically important as reoperation carries high risk. Noninvasive methods of hemodynamic assessment of patients with both aortic and mitral mechanical valves continue to be frustrated by the interference created by prosthetic material and direct left ventricular puncture may be required for definitive hemodynamic assessment. We report the hemodynamic and angiographic results and outcomes of 38 consecutive patients with double valve replacement who underwent left ventricular puncture as part of evaluation of possible prosthetic dysfunction. These results were compared with those obtained by noninvasive testing. We found noninvasive assessment alone to be unsatisfactory as measurements of regurgitation and stenosis correlated poorly with those obtained by direct left ventricular puncture. Important information that altered patient management was obtained from invasive assessment in 68% of cases with an acceptable rate of complications. Therefore, hemodynamic and angiographic assessment using transthoracic left ventricular puncture should be entertained in patients with mitral and aortic valve replacement presenting with congestive heart failure and suspected prosthesis dysfunction. |
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Authors:
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Darren L Walters; Pedro L Sanchez; Maximo Rodriguez-Alemparte; Pedro J Colon-Hernandez; Lisa A Hourigan; Igor F Palacios |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 58 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-03-24 Completed Date: 2003-07-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 539-44 Citation Subset: IM |
Copyright Information:
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Copyright 2003 Wiley-Liss, Inc. |
Affiliation:
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Cardiology Division, Medical Department, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Valve
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surgery*,
ultrasonography Echocardiography Female Follow-Up Studies Heart Catheterization / methods Heart Failure / diagnosis* Heart Valve Diseases / surgery*, ultrasonography Heart Valve Prosthesis* Hemodynamics / physiology Hospitals, General Humans Male Massachusetts Mitral Valve / surgery*, ultrasonography Prosthesis Failure Punctures Retrospective Studies Sampling Studies Sensitivity and Specificity Ventricular Dysfunction, Left / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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