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Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale!
Author(s) -
Buchholz Stefan,
Robaei Daniel,
Jacobs Neil H.,
Feneley Michael P.
Publication year - 2012
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2012.01775.x
Subject(s) - cardiology , hemodynamics , medicine , prosthesis , stenosis , pressure gradient , heart block , ventricular pressure , aortic valve replacement , aortic valve , aortic pressure , surgery , electrocardiography , geology , oceanography
High transvalvular pressure gradients following aortic valve replacement can be caused by several possible mechanisms. We present the case of an elderly woman with an elevated pressure gradient across an aortic valve bioprosthesis in the setting of complete heart block. After consideration of the presence of complete heart block, the hemodynamic profile of the specific prosthesis, and patient‐prosthesis mismatch, only a mild degree of stenosis was found to be attributable to degeneration of the prosthesis. There is no literature quantifying the hemodynamic effect of complete heart block on the pressure gradients across bioprosthetic aortic valves. In the case presented, the transvalvular peak and mean pressure gradients were reduced by 41% and 39%, respectively, following treatment of complete heart block by insertion of a permanent pacemaker.