Phantom aortic valve pressure gradient: discrepancies between cardiac catheterization and Doppler echocardiography.
We present a case of a patient scheduled for mitral valve replacement and possible aortic valve replacement. On Doppler examination, her peak transaortic pressure gradient measured on three separate occasions (pre-, intra-, and postoperatively) was approximately 60 mm Hg. In contrast, the peak-to-peak pressure gradient (cardiac catheterization) was 11 mm Hg. This latter gradient was confirmed in the operating room by direct simultaneous measurement of the pressures in the left ventricle and ascending aorta. Potential causes for this discrepancy are discussed, among which the "pressure recovery phenomenon" is considered the most important.
Popescu
Wanda M
WM
Departments of *Anesthesiology and †Surgery (Section of Cardiothoracic Surgery), Yale University School of Medicine; ‡Department of Radiology, Hospital of Saint Raphael, New Haven; and §Department of Medicine, Waterbury Hospital, Connecticut.
Prokop
Edward
E
Elefteriades
John A
JA
Kett
Kevin
K
Barash
Paul G
PG
D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology*; D006328:Cardiac Catheterization; D002302:Cardiac Output; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D011312:Pressure