| A tale of two pressures: A case of pseudo-prosthetic mitral valve stenosis. | |
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MedLine Citation:
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PMID: 22106062 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We present a case of an 83-year-old female with past medical history of rheumatic fever associated mitral stenosis for which she underwent mitral commissurotomy 25 years prior to presentation. Subsequently, she underwent coronary artery bypass grafting and mitral valve replacement with a bio-prosthetic valve 8 years prior to presentation. Presently, she started experiencing worsening dyspnea and heart failure symptoms. Echocardiography showed mildly reduced left ventricular ejection fraction with severe aortic stenosis and pulmonary hypertension. The bioprosthetic mitral valve was functioning normally. We performed right and left heart catheterization for evaluation. Peak aortic gradient was 50 mm Hg with a mean gradient of 39 mm Hg. Aortic valve area was calculated to be 0.31 cm(2) . However, simultaneous measurement of left ventricular and wedge pressures showed a significant gradient of 11 mm Hg across the mitral valve with a calculated mitral valve area of 0.4 cm(2) . Because of discordant information between echocardiographic and hemodynamic data, we proceeded with trans-septal puncture to directly measure left atrial pressures. Simultaneous left atrial and left ventricular pressure measurement demonstrated a mean gradient of 4 mm Hg across the mitral valve with an area calculated at 1.9 cm(2) . We review the tracings in detail and discuss the pitfalls of using pulmonary capillary wedge pressure as a surrogate for left atrial pressure. © 2011 Wiley Periodicals, Inc. |
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Authors:
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Syed S I Bokhari; William W O'Neill; Mauricio G Cohen |
Publication Detail:
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Type: Journal Article Date: 2011-07-21 |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 78 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 1022-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Wiley Periodicals, Inc. |
Affiliation:
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Elaine and Sidney Sussman Catheterization Laboratories, University of Miami Hospital, Miami, Florida. sbokhari@med.miami.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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