Clinical Uses of a Flow-Directed Right Heart Catheter

A small, flexible nylon catheter was introduced percutaneously and carried into the pulmonary artery (PA) by blood flow. Blood and pressures were obtained from the right ventricle or PA in 55 (86%) of 64 patients; 30 critically ill patients were studied in a coronary care unit. The catheter remained in nine patients for at least 36 hours for continuous monitoring. Eleven subjects with angina pectoris were tested with graded exercise loads to obtain objective assessment of drug or surgical therapy, or both. Pulmonary hypertension was present in three of nine patients thought to have mild acquired valvular disease; formal catheterization documented severe mitral valve disease in these three patients. Diagnosis was established in three of five patients with suspected congenital heart disease. The safety, simplicity, and elimination of fluoroscopy permit bedside studies and follow-up assessment of outpatients.