Chapter 17: Left Ventriculography from the Radial Approach

Left ventriculography is performed during diagnostic cardiac catheterization for evaluation of left ventricular structure and function. Additionally, ventriculography is very helpful to assess wall motion abnormalities and to evaluate for presence of a ventricular septal defect or mitral regurgitation during an emergency procedure (e.g., STEMI). Due to specific anatomic considerations required for the radial approach, specialized diagnostic and interventional catheters have been developed for radial coronary angiography and intervention. Recently, a dedicated radial ventriculography catheter was developed.

Catheters for Left Ventriculography

Pigtail Catheters

Traditionally, left ventriculography is performed with pigtail catheters. The advantage of pigtail catheters is that they allow for injection of contrast in the left ventricle with a power injector through multiple side holes in order to minimize arrhythmias and prevent myocardial staining or perforation. Multiple side holes permit for uniform contrast opacification of the left ventricle.

Author: 
Mladen I. Vidovich, MD, FACC, FSCAI