Portal de Periódicos da CAPES

Left heart catheterization with special reference to the transseptal method.

1966; BMJ; Volume: 28; Issue: 6 Linguagem: Inglês

10.1136/hrt.28.6.835

1468-201X

P.G.F. Nixon, Hamid Ikram,

Healthcare Policy and Management

to consider particularly the features concerned with their safety.It is not intended to review the results obtained by other cardiologists, because wide differences in the way that the techniques are practised make comparisons difficult, and most published reports have described small series. SUBJECTS AND METHODSThe patients' ages lay between 5 and 72 years.Of the 508 patients, 376 had mitral valvar disease with or with- out coincidental aortic lesion; 84 had aortic valvar disease, and 48 had a variety of congenital and acquired heart diseases.The majority of the mitral patients had sys- tolic murmurs or a previous heart operation, and the investigation was done to assess the relative importance of various factors: stenosis, re-stenosis, regurgitation, "the myocardial factor", coincidental aortic disease, or pulmonary vascular changes.Acting under the firm belief that tension and fear predispose the subject of left heart catheterization to com- plications, great attention was paid to the mental prepara- tion of the patient.Before the investigation he was made familiar with the catheterization laboratory where, from choice, the preliminary clinical examination and heart-sound recordings were carried out; and he came to know the various doctors, nurses, and technicians.The procedures that would require the patient's co-operation were carefully explained and rehearsed beforehand.A quiet demeanour, equanimity, and competence were required from the laboratory staff.Tachycardia and dyspnoea prevent the recording of diagnostic tracings, and, if necessary, investigation was deferred until medical treatment abolished tachycardia, allowed the patient to hold his breath without difficulty for at least 20 seconds, and enabled him to lie flat, or nearly flat, without dis- comfort.A highly penetrated postero-anterior teleradiogram of the chest (Fig. 1) was taken to show the relation of the left atrial shadow to the right heart border of the spine; and to allow measurement of the left atrial area, because enlargement of the left atrium modified the physiological on July 17,