Direct right ventricular puncture for hemodynamic evaluation of a mechanical tricuspid valve prosthesis: A new indication for an old procedure

Gibson, Mark; Carell, Edgar S.

doi:10.1002/(sici)1097-0304(199711)42:3<278::aid-ccd10>3.0.co;2-i

Cited by 5 publications

(2 citation statements)

References 23 publications

(29 reference statements)

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“…Ball-cage prostheses are likely to be less susceptible to catheter-induced complications due to absence of a hinge and leaflets. In the second reported case, the operator avoided the mechanical tricuspid prosthesis by performing direct puncture of the right ventricle from the chest wall 5. This approach allows right heart catheterisation in the absence of catheter-induced tricuspid regurgitation, but we felt that the risk of tamponade at the time of sheath removal was unacceptably high in an anticoagulated patient.…”

Section: Discussionmentioning

confidence: 99%

Right heart catheterisation may be cautiously performed through a mechanical valve prosthesis in the tricuspid position

Pettit¹,

Tsui

Parameshwar

2016

BMJ Case Reports

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Right heart catheterisation (RHC) may be performed through a mechanical valve prosthesis in the tricuspid position using a partially inflated pulmonary artery flotation catheter. Preprocedural preparation should include an ex vivo trial with an identical valve prosthesis and the type of catheter to be used for the procedure. The operator should expect immediate unloading of the right ventricle due to catheter-associated tricuspid regurgitation, but it is possible to estimate pulmonary vascular resistance using the Fick principle. The risk of catheter entrapment or damage to the prosthetic leaflets during the procedure is likely to be low. This risk may be acceptable to the clinician and the patient if pulmonary vascular resistance must be measured in order to determine eligibility for heart transplantation.

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Section: Discussionmentioning

confidence: 99%

Right heart catheterisation may be cautiously performed through a mechanical valve prosthesis in the tricuspid position

Pettit¹,

Tsui

Parameshwar

2016

BMJ Case Reports

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show abstract

“…Access to the heart has also been achieved by using a posterior translumbar approach [3] or a transbronchial approach [4], but these methods have thankfully been abandoned in favor of the safer and now more traditional percutaneous vascular access. Anterior thoracic puncture access to the heart is not new, having previously been described for direct access to the left ventricle [5, 6] or to the right ventricle [7] when mechanical prosthetic valves prevent a more traditional vascular approach. In addition, the transhepatic approach [8–10] continues to gain acceptance as a suitable access alternative in infants and children.…”

mentioning

confidence: 99%