A SAFE, RAPID METHOD OF TRANS-FEMORAL RETROGRADE LEFT-VENTRICULAR CATHETERIZATION IN VALVULAR AORTIC-STENOSIS

Experience with the use of a standard left Amplatz coronary catheter and a guidewire to cross the aortic valve in 34 patients being evaluated for valvular aortic stenosis is described. A no. 2 Amplatz left coronary catheter inserted via the femoral artery was positioned above the noncoronary aortic valve cusp with the tip aligned toward the aortic valve. This catheter allowed a soft-tipped, Teflon-coated guidewire to be guided through the aortic valve orifice. The catheter was then advanced over the guidewire into the left ventricle. This technique was successful within 6 min in 32 of 34 patients (94%). The stenotic aortic valve was crossed in < 2 min in 15 patients (42%) and in < 4 min in 31 (91%). The aortic valve was not crossed in 2 patients. Patients (21, 62%) had an aortic valve area of < 0.75 cm. There were no complications. This technique apparently provides a method for safe, rapid transaortic left ventricular catheterization in patients with aortic stenosis of all degrees of severity.