Cardiology Question for the Week of October 23, 2023

Question:

How is a left heart catheterization using the percutaneous retrograde technique performed?

Answer:

Left heart catheterization using the percutaneous retrograde technique is usually performed via the femoral, brachial or, occasionally, the axillary or radial artery with sterile technique, a local anesthetic,and appropriate sedation. A left heart catheterization may evaluate function of mitral and aortic valves as well as the coronary arteries. Also identified is left side aortic valve regurgitation, coronary artery disease such as stenosis or occlusion, mitral valve stenosis or regurgitation, ventricular hypertrophy or aneurysm. The catheterization procedure involves percutaneous insertion of a needle into the target artery followed by placement of a flexible guidewire, removal of the needle, insertion of a sheath/dilator system over the guidewire and subsequent insertion of an appropriate catheter through the sheath into the arterial system under fluoroscopic guidance. The catheter is advanced retrograde through the arterial system across the aortic valve and, most likely, into the left ventricle. A contrast injection in the left ventricle need not be performed to code for a left heart cath.

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