Utilization of a pressure sensor guidewire to measure bileaflet mechanical valve gradients: hemodynamic and echocardiographic sequelae.
Suspected prosthetic valve dysfunction is a difficult clinical problem, because of the high risk of repeat valvular surgery. Echocardiographic measurements of prosthetic valvular dysfunction can be misleading, especially with bileaflet valves. Direct measurement of trans-valvular gradients is problematic because of potentially serious catheter entrapment issues. We report a case in which a high-fidelity pressure sensor angioplasty guidewire was used to cross prosthetic mitral and aortic valves in a patient, with hemodynamic and echocardiographic assessment. This technique was safe and effective, refuting the inaccurate non-invasive tests that over-estimated the aortic valvular gradient.
Christiana Care Health System, Newark, Delaware, USA. andrew.doorey@cardioconsultants.net
Andrew J
AJ
Doorey
Mandip
M
Gakhal
Michael J
MJ
Pasquale
D000368:Aged; D017130:Angioplasty / Q000295:instrumentation*; D001021:Aortic Valve; D006328:Cardiac Catheterization / Q000295:instrumentation; D015150:Echocardiography, Doppler; D005260:Female; D016330:Frail Elderly; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D011475:Prosthesis Failure; D014160:Transducers, Pressure; D017725:Ventricular Pressure