{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T10:47:36Z","timestamp":1694947656795},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T00:00:00Z","timestamp":1489536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>Accurate evaluation of trans\u2010aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non\u2010invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans\u2010valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained. Obtaining access to the left ventricle via the mitral valve after a trans\u2010septal puncture is not feasible in the case of a concomitant mechanical mitral valve, whereas left ventricular apical puncture technique is associated with high procedural risks. Retrograde crossing of a bileaflet mechanical aortic prosthesis with standard catheters is associated with the risk of catheter entrapment and acute valvular regurgitation. In these cases, the assessment of trans\u2010valvular gradients using a 0.014\u02dd diameter coronary pressure wire technique has been described in a few case reports. We present the case of a 76\u2010year\u2010old female with rheumatic valvular heart disease who underwent mechanical aortic and mitral valve replacement in the past. She presented with decompensated heart failure and echocardiographic findings suggestive of elevated pressure gradient across the mechanical aortic valve prosthesis. The use of a high\u2010fidelity 0.014\u02dd diameter coronary pressure guidewire resulted in the detection of a normal trans\u2010valvular pressure gradient across the mechanical aortic valve. This avoided a high\u2010risk third redo valve surgery in our patient. \u00a9 2017 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ccd.26962","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T12:43:19Z","timestamp":1489581799000},"page":"193-199","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of trans\u2010aortic pressure gradient using a coronary pressure wire in patients with mechanical aortic and mitral valve prostheses"],"prefix":"10.1002","volume":"92","author":[{"given":"Nisharahmed","family":"Kherada","sequence":"first","affiliation":[{"name":"Division of Cardiology Mount Sinai Medical Center in affiliation with Columbia University Miami Beach Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Brenes","sequence":"additional","affiliation":[{"name":"Division of Cardiology Mount Sinai Medical Center in affiliation with Columbia University Miami Beach Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annapoorna S.","family":"Kini","sequence":"additional","affiliation":[{"name":"Division of Cardiology Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George D.","family":"Dangas","sequence":"additional","affiliation":[{"name":"Division of Cardiology Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,15]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"303","article-title":"Prognosis of reoperation for prosthesis dysfunction","volume":"85","author":"Nallet O","year":"1992","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)90313-X"},{"key":"e_1_2_5_4_1","first-page":"205","article-title":"A computerized physiologic pulse duplicator for in\u2010vitro hydrodynamic and ultrasonic studies of prosthetic heart valves","volume":"23","author":"Arabia FA","year":"1989","journal-title":"Biomed Instrum Technol"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00066-2"},{"key":"e_1_2_5_6_1","first-page":"155","volume-title":"Hemodynamic rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis","author":"Kern M.","year":"2009"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90042-1"},{"key":"e_1_2_5_8_1","first-page":"194","article-title":"Retrograde catheterization of left ventricle through mechanical aortic prostheses","volume":"9","author":"Horskotte D.","year":"1988","journal-title":"Eur Heart J"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1222"},{"key":"e_1_2_5_10_1","first-page":"359","article-title":"Feasibility of a pressure wire and single arterial puncture for assessing aortic valve area in patients with aortic stenosis","volume":"18","author":"Bae JH","year":"2006","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10596"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20675"},{"key":"e_1_2_5_13_1","first-page":"555","article-title":"PressureWire for comprehensive hemodynamic assessment in a patient with mechanical aortic and mitral valves","volume":"22","author":"Khouzam RN","year":"2010","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22548"},{"key":"e_1_2_5_15_1","first-page":"72","article-title":"Transradial measurement of transvalvular pressure gradient in the setting of mechanical aortic and mitral valve prostheses using a coronary fractional flow reserve guidewire","volume":"24","author":"Vales L","year":"2012","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.536"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.07.013"},{"key":"e_1_2_5_18_1","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/0735-1097(92)90486-7","article-title":"Effect of prosthetic aortic valve design on the Doppler\u2010catheter gradient correlation: an in vitro study of normal St. Jude, Medtronic\u2010Hall, Starr\u2010Edwards and Hancock valves. 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