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Hemodynamics of valvular disorders as measured by cardiac catheterization

Morton J Kern, MD, MSCAI, FAHA, FACC
Section Editors
Catherine M Otto, MD
Donald Cutlip, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Pressure waveforms obtained during cardiac catheterization can be used to diagnose and evaluate congenital or acquired valvular heart disease [1-3]. However, echocardiography provides adequate diagnostic data in most patients.

In a minority of patients with valvular heart disease (<5 percent), further evaluation with invasive intracardiac pressure measurements and/or angiography is needed because the echocardiographic data are nondiagnostic or there is a discrepancy between the clinical presentation and echocardiographic findings. Invasive hemodynamic measurements are also used to monitor therapeutic percutaneous procedures such as transcatheter aortic valve replacement, transcatheter mitral valve repair with a clip, and balloon valvotomy.

Coronary angiography is often needed before transcatheter valve implantation or surgery, but hemodynamic measurements are not recommended if noninvasive data are diagnostic.

An overview of the hemodynamics of stenotic and regurgitant valvular lesions, as measured by cardiac catheterization, will be provided here. The clinical characteristics of valvular heart disease are discussed separately.


Regardless of etiology, stenosis of the aortic valve causes obstruction to blood flow from the left ventricle to the aorta. As a result, there is a systolic pressure gradient across the valve with a higher pressure in the left ventricle than the aorta [4]. (See "Clinical manifestations and diagnosis of aortic stenosis in adults".)

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Literature review current through: Nov 2017. | This topic last updated: Feb 07, 2017.
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