scholarly journals A Novel Technique for Invasive Aortic Valve Pressure Gradient Measurement Using a 6Fr Swan-Ganz Catheter - Case Series

2021 ◽  
Author(s):  
Nayan Agarwal ◽  
Ujjwal Rastogi ◽  
Ahmed N Mahmoud ◽  
Deepak L Bhatt
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Pressure Gradient ◽  
Case Series ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Simple Method ◽  
Ventricular Outflow Obstruction ◽  
Left Ventricular Outflow ◽  
Gradient Measurement

Abstract Background Simultaneous left ventricular and aortic pressure gradient assessment has been rendered challenging since the recall of the Langston catheter. Here we describe a simple method for simultaneous left ventricular and aortic pressure gradient assessment using a Swan-Ganz catheter. Case Summary We describe 2 cases where assessment of simultaneous left ventricle and aortic valve gradients was done using a Swan-Ganz Catheter to assess the degree of aortic stenosis and dynamic left ventricular outflow obstruction. Discussion Using Swan-Ganz catheter assessment of simultaneous left ventricle and aortic valve gradients can simplify the procedure with reduced cost and increased patient safety.

Echocardiographic assessment of the aortic valve and left ventricular outflow tract

2005 ◽  
Vol 15 (S1) ◽  
pp. 27-36 ◽  
Author(s):  
Alfred Asante-Korang ◽  
Robert H. Anderson
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Heart ◽  
Transesophageal Echocardiogram ◽  
Left Ventricular Outflow ◽  
Echocardiographic Assessment

The previous reviews in this section of our Supplement1,2 have summarized the anatomic components of the ventriculo-arterial junctions, and then assessed the echocardiographic approach to the ventriculo-arterial junction or junctions as seen in the morphologically right ventricle. In this complementary review, we discuss the echocardiographic assessment of the comparable components found in the morphologically left ventricle, specifically the outflow tract and the arterial root. We will address the echocardiographic anatomy of the aortic valvar complex, and we will review the causes of congenital arterial valvar stenosis, using the aortic valve as our example. We will also review the various lesions that, in the outflow of the morphologically left ventricle, can produce subvalvar and supravalvar stenosis. We will then consider the salient features of the left ventricular outflow tract in patients with discordant ventriculo-arterial connections, and double outlet ventricles. To conclude the review, we will briefly address some rarer anomalies that involve the left ventricular outflow tract, showing how the transesophageal echocardiogram is used to assist the surgeon preparing for repair. The essence of the approach will be to consider the malformations as seen at valvar, subvalvar, or supravalvar levels,1 but we should not lose sight of the fact that aortic coarctation or interruption, hypoplasia of the left heart, and malformations of the mitral valve are all part of the spectrum of lesions associated with obstruction to the left ventricular outflow tract. These additional malformations, however, are beyond the scope of this review.

scholarly journals Left ventricular diastolic function in valvular aortic stenosis after aortic valve replacement

2002 ◽  
Vol 130 (3-4) ◽  
pp. 81-86
Author(s):  
Andjelka Ristic-Andjelkov
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Diastolic Function ◽  
Valve Replacement ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
First Year ◽  
Ventricular Outflow Obstruction ◽  
Left Ventricular Outflow ◽  
Valvular Aortic Stenosis

In adults with significant sympthomatic aortic valve stenosis, aortic valve replacement is therapy of choice. Replacement of the diseased aortic valve with a prosthetic valve yields relief of left ventricular outflow obstruction. Myocardial remodeling with regression of mass transpires as the heart adapts to the new level of after load. In patients with moderate left ventricular hypertrophy improvement in diastolic function during the first year after aortic valve replacement is visible, while in patients with extreme myocardial hypertrophic changes it was slower.

Systolic pressure gradients across the aortic valve and in the ascending aorta

1965 ◽  
Vol 209 (3) ◽  
pp. 557-563 ◽  
Author(s):  
Thomas E. Driscol ◽  
Richard W. Eckstein
Keyword(s):  
Aortic Valve ◽  
Pressure Gradient ◽  
Systolic Pressure ◽  
Left Ventricular Pressure ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Ventricular Pressure ◽  
Maximum Pressure ◽  
Early Systole ◽  
Systolic Pressure Gradient

Left ventricular and aortic pressure pulses and the pressure gradient across the aortic valve were recorded in anesthetized and unanesthetized dogs. Aortic pressure recorded immediately above the valve increased 5–15 msec before it was exceeded by left ventricular pressure. The maximum systolic pressure gradient occurred in early systole and remained positive throughout the ejection period. When aortic pressure was recorded 1–3 cm distal to the valve, these pressure pulse relationships were altered so that 1) the rise in aortic pressure was delayed, 2) the early systolic maximum pressure gradient was increased, and 3) aortic pressure exceeded ventricular pressure during the latter half of systole. The changes in early systole are due to a delay in the pulse wave reaching the more distal recording site. The mean systolic pressure gradient between two sites within the ascend-ing aorta was found to be negative, i.e., opposite to the direction of forward flow. The negative pressure gradient probably accounts for the reversal of the transvalvular pressure gradient in late systole when aortic pressure was recorded distal to the valve.

scholarly journals Clinical and echocardiographic characteristics of patients with pathology proven left-sided non-valvular papillary fibroelastoma

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E El-Am ◽  
A Ahmad ◽  
R Kurmann ◽  
A Sorour ◽  
M Bois ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Papillary Fibroelastoma ◽  
Left Ventricular Outflow

Abstract Funding Acknowledgements Type of funding sources: None. Background Papillary fibroelastoma (PFE) is now regarded as the most common primary tumor of the heart. Although benign, they are clinically significant for their high risk of embolization. They are most commonly found on cardiac valves but can also be present on non-valvular endocardial surfaces. The aim of this study was to better characterize patients with left-sided non-valvular PFE and its clinical sequelae. Methods We retrospectively identified patients with pathology-proven PFEs at a single center between January 1995 and December 2018 (n = 279). Patients with left-sided non-valvular PFE were analyzed. Medical records were retrospectively reviewed for clinical characteristics and outcomes. In addition, intra-operative transesophageal echocardiograms were manually reviewed to estimate overall size and location. Results During the study period, we identified 37 patients with left-sided non-valvular PFE (mean age 61 ± 14 years; 62% females) (Table). PFEs were located on the left ventricle in 41%, left atrium in 35%, and left ventricular outflow tract in 24% of patients. Around a quarter of patients (27%) had a diagnosis of hypertrophic cardiomyopathy, 19% had prior cardiac surgery, and 27% had cancer diagnosed prior to PFE diagnosis. Transient ischemic attack or stroke was the presenting symptom in 22% of patients, myocardial infarction in 6% and peripheral embolization in 6%. Median maximal length for PFE on the left ventricle was 11.1 mm [3;18], on the left atrium 9 mm [2;25], and left ventricular outflow tract 8 mm [6;13]. A minority of patients (9/37 [24%]) had associated valvular PFE on the mitral valve and/or aortic valve (1 patient had both mitral valve and aortic valve PFE, 7 had aortic valve PFE and 1 had Mitral valve PFE). Only 13 patients had follow up transthoracic/transesophageal echocardiogram 1 year after PFE removal; 4/13 (31%) had documented PFE recurrence (3 PFE recurred in the same location as the original; 1 in a different location). Conclusion Left-sided non-valvular PFE is associated with thromboembolic events and at least in those that had follow-up echocardiograms, had a high recurrence rate. More studies are needed to evaluate the management of patients with asymptomatic PFE. Abstract Figure. Baseline Characteristics

Sign in / Sign up

Export Citation Format

Share Document