[Heart valve surgery without heart catheter study].

The development of new non-invasive diagnostic techniques in cardiology and their validisation has questioned the up-to-now performed preoperative heart-catheterization for evaluation of valvular heart disease. Although all these methods--2-dimensional echocardiography, Doppler-sonography and nuclear techniques--offer a reliable judgement in regard to classification and operative indications, coronary heart disease can only be ruled out by coronarography--except in younger patients without risk-factors and angina. Also in acute valvular disease the invasive diagnostic measures give the heart surgeon more security as regards additional morphologic changes such as intimatears, fistulas or abscesses near the valve. The sensitivity of invasive methods is higher than that of 2-dimensional echocardiography. The expanding application of non-invasive diagnostic tools and with increasing experience it can be assumed that heart-catheterizations prior to surgical valvular repair can be done with more accuracy and not only as a routine.