title: Hemodynamic rounds series: Left heart catheterization and mitral balloon valvuloplasty in a patient with a mechanical aortic valve.
abstract: Patients with rheumatic heart disease and a history of mechanical aortic valve replacement will occasionally present with significant mitral stenosis for consideration of mitral balloon valvuloplasty. The conventional retrograde trans-aortic method for left heart catheterization cannot be done for patients with a mechanical aortic valve. We present a patient with a mechanical aortic valve who underwent successful left heart catheterization and mitral valvuloplasty via a transseptal approach. A 5 French pigtail catheter was advanced through the left atrial 8 French Mullins sheath into the left ventricle, for simultaneous pressure measurement across the mitral valve. This manuscript discusses the strengths and weaknesses of several approaches for left heart catheterization in patients with a mechanical aortic valve.
authors.affiliation: Division of Interventional Cardiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Kosmicki
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
mesh_terms: D000328:Adult; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods; D002404:Catheterization / Q000379:methods*; D002932:Cineangiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013318:Stroke Volume; D016896:Treatment Outcome; D017725:Ventricular Pressure