Summary of the Mayo Clinic experience with direct left ventricular puncture.

Hemodynamic assessment of patients with prosthetic valves can be challenging. Noninvasive techniques may be limited by interference from the prosthetic material, whereas access to the left ventricle for direct pressure measurements often is not possible using common methods. The technique of direct, percutaneous left ventricular puncture has been proven to be a safe method that often provides needed data to help manage difficult clinical situations. We report our 8-yr experience with this technique for assessment of patients with valvular prostheses. Direct left ventricular puncture is a safe technique in patients with prior cardiac surgery and provided significant diagnostic information in the set of patients with multiple valvular prostheses.