Evidence in the literature and our experience indicate that the postoperative course after mitral valvulotomy is often unsatisfactory if complicating significant aortic insufficiency is present. It would therefore be useful to know how much deleterious influence early aortic insufficiency has on the results of mitral commissurotomy. In the presence of a diastolic murmur on the left side of the sternum there often is no reliable clinical evidence to differentiate between a Graham Steell type of murmur due to pulmonary hypertension and that caused by aortic insufficiency. A balanced electrocardiogram may even add to the difficulty. We therefore deemed it necessary to find a more exact way of differentiating between the two possibilities.
Visualization of the aortic valve and demonstration of regurgitation into the left ventricle following injection of contrast material with use of conventional aortographic techniques usually gave unsatisfactory results because the material could not be injected rapidly enough to
MOLNAR W, NELSON SW, KLASSEN KP, RYAN JM. Aortic Valvulography and Ascending Aortography. AMA Arch Surg. 1959;79(4):683-687. doi:10.1001/archsurg.1959.04320100149025