The evaluation of the degree of mitral insufficiency by selective left ventricular angiocardiography

Björk, Viking Olov; Lodin, Herman; Malers, E

doi:10.1016/0002-8703(60)90352-5

Cited by 70 publications

(7 citation statements)

References 9 publications

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“…without the square root sign. A left ventriculography was performed in the right anterior oblique projection and a grade ++ mitral regurgitation was noted (5). The right atrial angiogram showed a distance of IS mm between the right atrial endocardium and the right border of the cardiac silhouette, and ruled out pericardial effusion.…”

Section: Case Reportmentioning

confidence: 99%

Reversibility of Alcoholic Cardiomyopathy with Abstention from Alcohol

Baudet¹,

Rigaud²,

Rocha³

et al. 1979

Cardiology

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A 46-year-old chronic alcoholic patient with typical and severe congestive cardiomyopathy was studied hemodynamically on two separate occasions. The second study followed after a 1½-year period of virtually complete abstention from alcohol and revealed that the left ventricular dysfunction had disappeared. Despite persisting atrial fibrillation, the response to moderate exercise and to plasma volume expansion was within the normal range. When last seen, 29 months after initial hospitalization, the patient was symptom-free and was not given any treatment.

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Section: Case Reportmentioning

confidence: 99%

Reversibility of Alcoholic Cardiomyopathy with Abstention from Alcohol

Baudet¹,

Rigaud²,

Rocha³

et al. 1979

Cardiology

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“…Angiocardiography with left ventricular contrast injection offers a means of directly visualizing regurgitation into the left atrium. Biplane radiography in the antero-posterior and lateral positions using a rapid serial film changer is the method generally employed (Bjork, Lodin, and Malers, 1960;Steiner et al, 1963); oblique projections and cine-radiography have also been used (Ross and Criley, 1962).We consider that the method which most accurately assesses the various grades of regurgitation is cine-radiography following left ventricular contrast injection with the patient in the right anterior oblique position. In addition objective information is obtained concerning cusp mobility.…”

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confidence: 99%

Cine-Angiocardiography of the Mitral Valve

Rees¹,

Jefferson²,

Harris³

1965

Heart

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The severity of mitral regurgitation when associated with stenosis is often doubtful after clinical electrocardiographic and standard radiological examinations are completed. By the use of the available indirect methods for the assessment of mitral regurgitation, it is often impossible to distinguish between mild and moderate regurgitation, a vital distinction when considering a closed mitral valvotomy.In the analysis of left atrial pressure tracings, attention has been directed to the height and shape of the V wave (Lagerlof and Werko, 1949;Gorlin et al., 1952; Biorck et al., 1953;Logan and Turner, 1953;Connolly et al., 1955) and to the Y descent expressed as the RY/V ratio (Owen and Wood, 1955). While the use of the Y descent provides a guide to the type of valve lesion present, an occasional case of dominant mitral regurgitation has a small systolic wave and an RY/V ratio within the stenotic range (1.7). Dye dilution techniques have been employed to assess mitral regurgitation but detection of a slight degree is difficult (Korner and Shillingford, 1955). The technique of assessing the severity of mitral regurgitation by the injection of indicator into the left ventricle, while blood is sampled simultaneously from the left atrium and from a peripheral artery, suffers from the same inaccuracies due to inadequate mixing, and the distinction of mild and moderate regurgitation is impossible (Polissar and Rapaport, 1961;Jose and Bernstein, 1962). More recently the apex cardiogram has been used, but this method is insufficiently sensitive to distinguish between mild and moderate regurgitation (Nixon and Wooler, 1963). Angiocardiography with left ventricular contrast injection offers a means of directly visualizing regurgitation into the left atrium. Biplane radiography in the antero-posterior and lateral positions using a rapid serial film changer is the method generally employed (Bjork, Lodin, and Malers, 1960;Steiner et al., 1963); oblique projections and cine-radiography have also been used (Ross and Criley, 1962).We consider that the method which most accurately assesses the various grades of regurgitation is cine-radiography following left ventricular contrast injection with the patient in the right anterior oblique position. In addition objective information is obtained concerning cusp mobility. In this paper, our experience with this technique as a pre-operative assessment for mitral valve surgery is described. We felt that the investigation would be valuable in mitral stenosis when there was clinical doubt as to the degree of regurgitation; in combined mitral and aortic valve disease when the dominant lesion was uncertain (in these a further cine-angiogram of the aortic valve was obtained following injection of contrast into the ascending aorta to assess the degree of aortic regurgitation); and in pure mitral regurgitation when there was a possibility of ruptured chordch tendinee. SUBJECTS AND METHODSThirty-two cine-angiocardiograms were obtained in 31 patients. They represent a small proportion of all cases...

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“…The main indications for the procedure were aortic stenosis or mitral insufficiency, and our results with it were recently reported. [7][8][9] The investigation is performed with the patient in the fasting state, under penicillin prophylaxis with blood and necessary equipment for cardiac resuscitation in readiness. In adult patients general anesthesia is not used, only premedication with morphine and scopolamine.…”

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confidence: 99%

Sequelae of Left Ventricular Puncture with Angiocardiography

et al. 1961

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T HE LEFT VENTRICLE may be catheterized from the aorta,1-3 from the left atrium by several routes,46 or may be directly punctured. Since 1958 we have performed left ventricular puncture in 142 cases for pressure measurements and contrast injection. It is the aim of this paper to report our complications together with a review of those reported by others.Material and Methods Our cases were 6 months to 56 years old, most between 30 and 40 years of age. The diagnoses are presented in table 1. The main indications for the procedure were aortic stenosis or mitral insufficiency, and our results with it were recently reported.7-9The investigation is performed with the patient in the fasting state, under penicillin prophylaxis with blood and necessary equipment for cardiac resuscitation in readiness. In adult patients general anesthesia is not used, only premedication with morphine and scopolamine. The puncture is performed by a thoracic surgeon in the presence of a cardiologist, an anesthesiologist, and a radiologist. We use the intercostal method of Brock et al. 10' 11 We only wish to stress that the needle used has a blunt end and a sharp mandrin. When the ventricular cavity is reached, the needle is locked by a screw so that it cannot be introduced farther. An electrocardiogram is continually monitored on a two-beam cathode-ray oscilloscope. The pressure curves from the left ventricle and a peripheral artery are recorded. The ventricular curve must be free and undamped up to the moment of contrast injection and during slight changes in the position of the needle, in order to avoid intramyocardial deposition of contrast medium. With an automatic pressure syringe we then inject 1 to 1.2 ml. per Kg. of body weight of 76 per cent Urografin, with a speed of about From the Department of Thoracic Surgery (Head:

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The evaluation of the degree of mitral insufficiency by selective left ventricular angiocardiography

Cited by 70 publications

References 9 publications

Reversibility of Alcoholic Cardiomyopathy with Abstention from Alcohol

Reversibility of Alcoholic Cardiomyopathy with Abstention from Alcohol

Cine-Angiocardiography of the Mitral Valve

Sequelae of Left Ventricular Puncture with Angiocardiography

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