Sequelae of Left Ventricular Puncture with Angiocardiography

Material and Methods Our cases were 6 months to 56 years old, most between 30 and 40 years of age. The diagnoses are presented in table 1. The main indications for the procedure were aortic stenosis or mitral insufficiency, and our results with it were recently reported.7-9 The investigation is performed with the patient in the fasting state, under penicillin prophylaxis with blood and necessary equipment for cardiac resuscitation in readiness. In adult patients general anesthesia is not used, only premedication with morphine and scopolamine. The puncture is performed by a thoracic surgeon in the presence of a cardiologist, an anesthesiologist, and a radiologist. We use the intercostal method of Brock et al.10' 11 We only wish to stress that the needle used has a blunt end and a sharp mandrin. When the ventricular cavity is reached, the needle is locked by a screw so that it cannot be introduced farther. An electrocardiogram is continually monitored on a two-beam cathode-ray oscilloscope. The pressure curves from the left ventricle and a peripheral artery are recorded. The ventricular curve must be free and undamped up to the moment of contrast injection and during slight changes in the position of the needle, in order to avoid intramyocardial deposition of contrast medium. With an automatic pressure syringe we then inject 1 to 1.2 ml. per Kg. of body weight of 76 per cent Urografin, with a speed of about