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      Hemodynamic Changes during Retrograde Left-Heart Catheterization in Patients with Aortic Stenosis

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          Pulmonary artery pressures in patients with aortic stenosis have been related to postoperative prognosis and surgical risk. However, while right- and left-heart pressures should be measured simultaneously, a catheter lying across the stenotic aortic valve might alter left- and right-heart pressures. To assess this phenomenon, right- and left-heart pressures were recorded before and after retrograde crossing of the aortic valve in 51 patients (30 patients with and 21 without aortic stenosis). In aortic stenosis, the mean pulmonary artery pressure increased (p < 0.001) after transaortic valvular pressure catheter placement (average 4 mm Hg, peak 19 mm Hg); in the absence of aortic stenosis, the mean pulmonary artery pressure did not change (average 0 mm Hg; NS). A similar response was noted for the mean pulmonary capillary wedge pressure. Hemodynamic changes did not correlate with the severity of aortic stenosis or with left ventricular performance. Right-heart pressures should be determined without transaortic valvular catheter in place, if accurate interpretation of the hemodynamic effects of aortic stenosis is to be achieved.

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          Author and article information

          S. Karger AG
          12 November 2008
          : 78
          : 3
          : 171-178
          Division of Cardiology, Cornell University Medical College, The New York Hospital-Cornell Medical Center, New York, N.Y., USA
          174783 Cardiology 1991;78:171–178
          © 1991 S. Karger AG, Basel

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          Page count
          Pages: 8
          Catheterization and Interventional Cardiology


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