Pulmonary valve obstruction during cardiac catheterization.

OBSTRUCTION of a stenotic pulmonary valve by the exploring cardiac catheter, a serious and not infrequent complication of cardiac catheterization, has received little attention in the literature.1-4 Experiences in this laboratory indicate that pulmonary valve obstruction can occur both in a manifest, symptomatic form and in a concealed, asymptomatic form in patients with severe pulmonary stenosis. As catheterization studies are extended more generally to the infant age group and performed more often without anesthesia, the high incidence reported in this study may be more generally observed. The purpose of this communication is to present clinical and physiologic observations during pulmonary valve obstruction and to derive from these a concept of the precarious hemodynamic status that exists in severe congenital pulmonary valvular stenosis.