title: The pressure wire as a diagnostic tool in patients with congenital cardiac disease.
abstract: The pressure wire has emerged as a useful tool to assess the clinical severity of moderate coronary artery lesions. We report a novel use of the pressure wire in adult patients with complex congenital cardiac disease in whom it was used in assessing pressures beyond the stenosis in the distal pulmonary artery, aorto-pulmonary collaterals, and across prosthetic tricuspid valves, where conventional catheters were unable to reach. We used this in three of our patients for assessment of pulmonary artery pressures and in two patients for assessment of pressures across a prosthetic St Jude® valve. Out of the three patients referred for assessment, only two had significantly raised distal pulmonary pressures enabling them to receive appropriate therapy. Out of the two patients with a prosthetic tricuspid valve, only one required surgery based on this assessment. We describe a novel use of the pressure wire in the functional assessment of adults with congenital cardiac disease in whom conventional catheter techniques may not be able to provide adequate data. It can be a guide to provide appropriate therapy and avoid unnecessary interventions in this patient group.
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, University of Central Manchester Foundation NHS Trust, Oxford Road, Manchester, United Kingdom.
authors.forename: Tahir
authors.initials: T
authors.lastname: Hamid
authors.forename: Haider
authors.initials: H
authors.lastname: Hadi
authors.forename: Bernard
authors.initials: B
authors.lastname: Clarke
authors.forename: Vaikom
authors.initials: V
authors.lastname: Mahadevan
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000077300:Bosentan; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods*; D004417:Dyspnea / Q000150:complications; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D013449:Sulfonamides / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D013449:Sulfonamides; D000077300:Bosentan