Retrograde Left Ventricular Angiocardiography and Aortography

Abstract

The results and complications in 102 consecutive retrograde left ventricular angiocardiograms or thoracic aortograms were reviewed. There was no difference in ability to reach the ascending aorta between the femoral and brachial routes of entry. Attempts were made to enter the left ventricle from the ascending aorta in 74 instances with success in 60. Passage across the valve was nearly always accomplished when the valve was normal but could be achieved in only half with aortic stenosis. There were 2 deaths, one from ventricular fibrillation when the catheter was first introduced into the ascending aorta and one from a large well organized thrombotic coronary embolus. Other complications included intra-myocardial injection of dye (2) hypotension (3) and local arterial problems (10). Retrograde left ventricular angiocardiography or thoracic aortography is the most suitable approach for the evaluation of aortic or mitral insufficiency or a combination of these lesions. Complications are relatively small in comparison with direct percutaneous left ventricular puncture but are higher than those from right heart catheterization and pulmonary artery angiography.