Cineaortography in the assessment of aortic regurgitation: a comparison of different catheter types

The accuracy in diagnosing aortic regurgitation was studied in 170 consecutive cineaortograms. In 85 patients (group A) cineaortograms were undertaken with Sones or Gensini catheters, which produce a jet of contrast material directed towards the aortic valve. The other 85 patients (group B) underwent cineaortography with pigtail catheters, which may cause more equal distribution of contrast material in the aortic root. In group A, 31 of 71 patients (44%) without clinically known aortic valve disease showed angiographic grade I-III/IV aortic regurgitation. In group B only 8 of 61 patients (13%) without clinical evidence of aortic valve disease had grade I-II/IV aortic regurgitation on cineaortography. This difference is statistically significant (P less than 0.001). We conclude that catheters which produce a jet of contrast medium directed straight at the aortic valve can cause artificial trivial to moderate aortic regurgitation. Angiographic evaluation of aortic regurgitation should be performed with a catheter such as a pigtail or closed-end multiple sidehole catheter in which the contrast medium is not directed straight at the aortic valve.