A New Method of Left Ventricular Catheterization

Littmann, David; Starobin, Oscar E.; Hall, Jack H.; Matthews, Robert J.; Williams, John A.

doi:10.1161/01.cir.21.6.1150

Cited by 11 publications

(3 citation statements)

References 11 publications

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“…As contribuições de Odman 41 e Olin 30 , em 1958, equiparam os cateteres com furos laterais e ponta curva mais flexível que o corpo do cateter ("pigtail"), para prevenir esses inconvenientes durante a ventriculografia. Littmann et al 61 demonstraram sua fácil passagem através da valva aórtica normal e Bellman et al 62 e Williams et al 63 usaram-no com êxito para angiografia aórtica e coronariana em humanos.…”

Section: Angiocardiografiaunclassified

1929-2009: 80 Anos de cateterismo cardíaco - uma história dentro da história

Gottschall¹

2009

Rev. Bras. Cardiol. Invasiva

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Section: Angiocardiografiaunclassified

1929-2009: 80 Anos de cateterismo cardíaco - uma história dentro da história

Gottschall¹

2009

Rev. Bras. Cardiol. Invasiva

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“…In mitral valve disease, retrograde catheterization seems the best method for obtaining left ventricular pressures. Littman et al (1960) report that a curved catheter tip will pass easily through a normal aortic valve. Retrograde catheterization is difficult in severe aortic stenosis, but is usually possible if there is associated regurgitation.…”

Section: Left Heart Pressures 323mentioning

confidence: 99%

Selection of Techniques for the Measurement of Left Heart Pressures

Hamer¹,

Dow²

1961

Heart

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The technique of venous catheterization gives only indirect information about lesions of the left side of the heart. Analysis of mitral valve disease was made possible by the discovery that a venous pressure pulse could be obtained from a catheter wedged in a peripheral pulmonary artery (Lagerlof and Werko, 1949;Hellems et al., 1949). The form of the arterial pulse has been used for the indirect evaluation of aortic valve disease (Hancock and Abelman, 1957;, and in recent years several techniques for direct measurement of left heart pressures have been introduced. Puncture of a cardiac chamber is usually necessary, and the risk of these methods is considerably greater than that of the right heart catheterization.Whenever haemodynamic study is thought necessary, the type of investigation to be performed must be decided with regard to the abnormality present and the information required. The value of the data to be obtained must be considered in relation to the morbidity of the procedure. Right heart catheterization alone is often decisive, and left heart pressure measurements should be reserved for situations in which they will provide critical information.In the present study, emphasis is placed on the accurate measurement of the pressure gradient across the mitral or aortic valve, with simultaneous estimation of the cardiac output. Assessment of regurgitant flow by indicator dilution (Carleton et al., 1960; Warner and Toronto, 1958) METHODSThe methods used have been described previously (Davila et al., 1959). Central arterial pressure was recorded continuously using the Seldinger (1953) method. Right heart catheterization was performed for the measurement of pulmonary arterial and wedge pressures. Left atrial pressures were obtained by transbronchial puncture using a slotted bronchoscope which could be removed leaving the needle in place. Left ventricular pressures were recorded by direct puncture through the anterior chest wall (Brock et al., 1956) or by retrograde arterial catheterization using a Cournand catheter inserted in the right brachial artery (Voci and Hamer, 1960).Simultaneous pressure measurements were made on either side of the mitral or aortic valves while cardiac output was estimated by the Fick method. Pressures were recorded with P23Db Statham strain-gauges and a 4-channel direct writing Sanborn Polyviso with optimal damping, and were replotted on the same scale without correction for phase lag. The base-line for all pressure measurements was the middle of the chest at the level of the second costal cartilage . The Ry/v ratio (Owen and Wood, 1955) was calculated from left atrial pressures adjusted to a base-line at the level of the sternal angle. Blood oxygen contents were determined by the Van

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“…[12][13][14][15][16] Ideally, any method of catheterization should be relatively simple, have a high rate of success and a low incidence of complications. In 1950, Zimmerman,3 for the first time, achieved retrograde catheterization of the left ventricle utilizing an arterial catheter for this and other purposes.…”

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confidence: 99%

Retrograde Catheterization of the Systemic Circulation with the Loop-End Catheter

1966

Self Cite

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Catheterization of the left ventricle and aorta has provided invaluable data in the characterization of aortic and mitral valve as well as coronary artery lesions. Despite its routine use and the description of various technics, there is as yet no standard method which has been adopted by most laboratories.As initially reported by Farinas in 19411 and Radner in 1947,~ human arterial catheterization was performed by the direct insertion of a catheter into an artery. In 1950, Zimmerman,3 for the first time, achieved retrograde catheterization of the left ventricle utilizing an arterial catheter for this and other purposes. Limon4 during the same year proclaimed the method both effective and safe, while somewhat later, Sodi-Pallares5 concurred in the safety of arterial catheterization, at least for human intra-ventricular electrocardiography. In 1953, Seldinger6 developed an ingenious technique by means of which large catheters could be passed without surgical dissection. It required only a clean vascular puncture with a needle of modest size and a specially fabricated flexible wire guide over which the catheter was introduced. Prioton7 7 in 1957 catheterized the left ventricle using a modification of Seldinger's method and this, in various forms, soon came into general use.g-1° The loopend catheter described by Williamsll in 1960 was subsequently adopted in other laboratories. [12][13][14][15][16] Ideally, any method of catheterization should be relatively simple, have a high rate of success and a low incidence of complications. We believe that retrograde catheterization of the aorta and left ventricle with the loop-end catheter is safe, simple, direct and practical.The present report summarizes our experience with 235 patients in whom 250 percutaneous retrograde arterial studies were performed with the loop-end catheter. MATERIALS AND METHODSAll examinations were obtained between November, 1962 and April, 1964. Only 5 of the 235 patients were women. The average age was 46 with a range at Bibliothekssystem der Universitaet Giessen on June 23, 2015 ang.sagepub.com Downloaded from

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A New Method of Left Ventricular Catheterization

Cited by 11 publications

References 11 publications

1929-2009: 80 Anos de cateterismo cardíaco - uma história dentro da história

1929-2009: 80 Anos de cateterismo cardíaco - uma história dentro da história

Selection of Techniques for the Measurement of Left Heart Pressures

Retrograde Catheterization of the Systemic Circulation with the Loop-End Catheter

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