Q. What is Cardiac Catheterization?

Routine cardiac catheterization is not necessary in patients with mitral regurgitation. It may be done when there is discrepancy between clinical findings and non invasive tests or preoperatively to do coronary angiography before mitral valve replacement in a patient in whom associated coronary artery disease is a possibility. Pressure tracings may show a prominent ‘v' wave in pulmonary capillary wedge tracings but this in neither a sensitive nor specific finding even in a patient with severe mitral regurgitation as height of ‘v' wave depends upon left atrial compliance.

Exercise hemodynamics may provide additional information. Left ventricular angiography may give a qualitative assessment of mitral regurgitation but this is not an objective method. Quantification of mitral regurgitation has been attempted by measuring forward cardiac output by Fick's method and stroke volume by left ventricular angiogram, but this is highly erroneous. However, left ventricular angiogram gives information about left ventricular size, function, severity of mitral regurgitation and regional wall motion abnormalities.