Usefulness and limitations of invasive diagnostic procedures in assessment and quantification of valvular lesions.
With increasing number of noninvasive techniques in clinical cardiology, the question emerges whether it is still justified to continue with cardiac catheterization in the assessment of valvular lesions on a routine basis. Therefore, advantages and disadvantages of invasive and noninvasive procedures are compared with respect to the information they provide in patients with valvular heart disease. Usefulness of invasive criteria in the assessment and quantification of valvular lesions have been analyzed. Limitations of these invasive criteria are derived from a score relating the accuracy obtained to the methodical expense incurred with a given diagnostic parameter. From these analyses and in consideration of findings in the literature, we conclude that cardiac catheterization is not only justified but necessary, particularly in patients prior to valve surgery in order to quantitate the valvular lesion, differentiate between valvular and myocardial dysfunction and screen for associated abnormalities such as concomitant coronary artery disease. Despite the progress in recent years, noninvasive techniques cannot provide this combination of precise information.
D001022:Aortic Valve Insufficiency / Q000175:diagnosis; D001024:Aortic Valve Stenosis / Q000175:diagnosis; D006328:Cardiac Catheterization / Q000379:methods; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D006349:Heart Valve Diseases / Q000175:diagnosis*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000175:diagnosis; D011877:Radionuclide Imaging