The severity of aortic stenosis can be judged by measuring the pressure difference across the valve. Because the difference changes with flow, concomitant cardiac output determinations are desirable. The safest, easiest, and most reliable method of measuring this difference is by left heart catheterization with direct percutaneous puncture of the left ventricle. This puncture is combined with a direct brachial artery recording and is performed at the same time as right heart catheterization. Left ventricular puncture has been carried out in 50 consecutive patients without any complication. This procedure is a valuable tool both in the preoperative selection and in the postoperative evaluation of patients undergoing surgery for aortic stenosis.
Connolly JE. LEFT VENTRICULAR PUNCTURE IN THE ASSESSMENT OF AORTIC STENOSIS. JAMA. 1959;171(2):160–163. doi:10.1001/jama.1959.03010200028008
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