Myocardial perforation associated with the use of the Gensini ventriculography catheter

Left ventricular perforation during cardiac catheterization in a case of severe calcific aortic stenosis. Should we cross the valve?

“…Most involved the cardiac chambers, particularly the right atrium (33 cases), right ventricle (21 cases), left atrium (10 cases), and left ventricle (10 cases) .Use of stiffer catheters (NIH, Temporary pacing leads, endomyocardial biopsy bioptomes, transseptal catheterization) and elderly women (>65 years) are risk factors associated with increased incidence of perforation. The Teflon Gensini catheter has been associated with higher complication rates when used for LVangiograms in the setting of severe aortic stenosis [2]. Once perforation occurs bradycardia and hypotension occur due to vagal stimulation [3].…”