PRESSURE RECOVERY IN AORTIC-VALVE STENOSIS

Background Pressure recovery is the variable increase in lateral press ure downstream from a stenotic orifice. The magnitude and clinical sig nificance of pressure recovery in aortic valve stenosis are poorly def ined. Methods and Results We obtained high-fidelity pressure and veloc ity recordings in 11 patients with isolated significant aortic valve s tenosis at the time of diagnostic cardiac catheterization. Systematic catheter pullback from the left ventricular cavity revealed a consiste nt although variable subvalvular gradient. Further pullback across and distal to the region of the stenosed aortic valve revealed a consiste nt and progressive increase in the ascending aortic pressure. This inc rease in lateral pressure occurred pari passu with a diminution in amp litude of the velocity pulse. The extent of pressure recovery was dire ctly related to systemic blood flow and transvalvular flow but inverse ly related to the Gorlin-derived aortic valve area. Conclusions These findings have potentially important implications for the hemodynamic e valuation of mild to moderately severe aortic valve stenosis. The exte nt of pressure recovery may be of additional utility in the assessment of aortic valve stenosis under varying physiological states.