Simultaneous measurement of aortic and left ventricular pressures in aortic stenosis using a double lumen pigtail catheter

Double-lumen catheter assessment of aortic stenosis: comparison with separate catheter technique

Hemodynamic assessment of aortic stenosis in the catheterization laboratory accurate determination of the transvalvular gradient. A commercially available double-lumen pigtail catheter can be used to obtain this gradient via a single arterial puncture. The catheter has several advantages over other methods used to measure the gradient in aortic stenosis, but it has not been critically evaluated. In order to assess the performance of this catheter compared to the traditional standard of separate catheters above and across the aortic valve, we studied 10 patients with aortic stenosis using both catheter systems. Aortic valve areas ranged from 0.34 cm2 to 1.1 cm2. Linear regression analysis confirmed excellent correlation between the two methods in measurement of the mean transvalvular gradient (r = 0.98) and calculation of the aortic valve area (r = 0.99) using the Gorlin formula. We conclude that the double-lumen pigtail catheter provides accurate data in the hemodynamic evaluation of aortic stenosis.

An improved catheter design for crossing stenosed aortic valves

Retrograde catheterization of the left ventricle in patients with aortic valve stenosis is commonly performed using a pigtail or coronary arterial catheter. This approach, although usually ultimately successful, may be highly tedious. To overcome the limitations of these conventional catheter shapes, we have designed a catheter specifically for crossing stenotic aortic valves. In a group of 17 patients, mean aortic valve area 0.75 cm2, the average time to cross the aortic valve was 2 minutes 45 seconds and the median time 30-40 seconds. Once the proper size catheter was selected, the average time to cross was 59 seconds. The success of this catheter is based on the operator's ability to "scan" or interrogate the surface of the valve thoroughly by manipulating the catheter and a moveable core straight tip guidewire.