Left heart catheterization has become an important diagnostic procedure for the evaluation of the circulatory dynamics in mitral and aortic valvular defects. Four main techniques have been advocated: the transbronchial, the transthoracic and transseptal left atrial puncture, and percutaneous puncture of the left ventricle.1-4 The technique, the diagnostic value, the advantage and complications of these methods were discussed by several authors.5-7 It might be difficult for the beginner in left heart catheterization to decide which method to use. Further reports of the different techniques are therefore desirable to evaluate their final value and their risk in the diagnostic armamentarium of the cardiologist.
Complete evaluation of the hemodynamics should include simultaneous measurement of cardiac output and the pressure recording during left heart catheterization. Cardiac output is usually measured by the Fick principle. The mixed pulmonary artery blood sample can be obtained by regular right heart catheterization with a radio-opaque