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Discrepancies between catheter and Doppler estimates of valve effective orifice area can be predicted from the pressure recovery phenomenon

practical implications with regard to quantification of aortic stenosis severity

Damien Garcia, Eng^*, Jean G. Dumesnil, MD, FACC, Louis-Gilles Durand, Eng, PhD^*, Lyes Kadem, Eng and Philippe Pibarot, DVM, PhD, FACC^*,*

^* Laboratoire de Génie Biomédical, Institut de Recherches Cliniques de Montréal, Montreal, Canada
Quebec Heart Institute/Laval Hospital, Laval University, Sainte-Foy, Quebec, Canada

View larger version (22K): [in a new window]   Figure 1 Relationship between valve effective orifice area (EOA) measured by a catheter using the maximal transvalvular pressure gradient (EOAcath/max) and EOA measured by Doppler echocardiography (EOADop). Open triangles and open squares represent in vitro (n = 172) and animal (n = 65) data, respectively. The solid and dotted lines represent the identity and regression lines, respectively. The regression line was constructed including the whole data set (in vitro and animal data). Several data points are superimposed.

View larger version (24K): [in a new window]   Figure 2 Relationship between valve effective orifice area (EOA) measured by a catheter using the net transvalvular pressure gradient (EOAcath) and EOA measured by Doppler echocardiography (EOADop) or, in the case of the data from Schöbel et al. (14), the EOA measured by a catheter using the maximal transvalvular pressure gradient (EOAcath/max). Open triangles, open squares, and closed circles represent in vitro data (n = 172), animal data (n = 65), and data from Schöbel (n = 37), respectively. The solid and dotted lines represent the identity and regression lines, respectively. The regression line was constructed including the whole data set (in vitro, animal, and patient data).

View larger version (23K): [in a new window]   Figure 3 Relationship between valve effective orifice area (EOA) measured by a catheter using the net transvalvular pressure gradient (EOAcath) and ELCo. A format similar to that of Figure 2 is used.