Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale
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 pr...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2012-10, Vol.29 (9), p.E218-E220 |
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| creator | Buchholz, Stefan Robaei, Daniel Jacobs, Neil H. Feneley, Michael P. |
| description | 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.
Mini‐
We present a case of elevated pressure gradients across an aortic valve bioprosthesis in the setting of complete heart block. After permanent pacemaker insertion and consideration of the hemodynamic profi le of the specifi c prosthesis and the presence of 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 insertion of a permanent pacemaker. |
| doi_str_mv | 10.1111/j.1540-8175.2012.01775.x |
| format | Article |
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Mini‐
We present a case of elevated pressure gradients across an aortic valve bioprosthesis in the setting of complete heart block. After permanent pacemaker insertion and consideration of the hemodynamic profi le of the specifi c prosthesis and the presence of 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 insertion of a permanent pacemaker.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/j.1540-8175.2012.01775.x</identifier><identifier>PMID: 22747659</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Aged ; aortic stenosis ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - surgery ; Arterial Pressure ; Bioprosthesis - adverse effects ; Echocardiography - methods ; False Positive Reactions ; Female ; Heart Block - diagnostic imaging ; Heart Block - etiology ; Heart Valve Prosthesis - adverse effects ; Humans ; Reproducibility of Results ; Sensitivity and Specificity ; Treatment Outcome</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2012-10, Vol.29 (9), p.E218-E220</ispartof><rights>2012, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3155-2ff910a23de25ea2e58c13ca472713d4abb82e4f1d5289adbdefedda548fa4413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1540-8175.2012.01775.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1540-8175.2012.01775.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22747659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Buchholz, Stefan</creatorcontrib><creatorcontrib>Robaei, Daniel</creatorcontrib><creatorcontrib>Jacobs, Neil H.</creatorcontrib><creatorcontrib>Feneley, Michael P.</creatorcontrib><title>Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>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.
Mini‐
We present a case of elevated pressure gradients across an aortic valve bioprosthesis in the setting of complete heart block. After permanent pacemaker insertion and consideration of the hemodynamic profi le of the specifi c prosthesis and the presence of 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 insertion of a permanent pacemaker.</description><subject>Aged</subject><subject>aortic stenosis</subject><subject>Aortic Valve Stenosis - complications</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Arterial Pressure</subject><subject>Bioprosthesis - adverse effects</subject><subject>Echocardiography - methods</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>Heart Block - diagnostic imaging</subject><subject>Heart Block - etiology</subject><subject>Heart Valve Prosthesis - adverse effects</subject><subject>Humans</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Treatment Outcome</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFFPwjAQxxujEUS_gumjL5tt17LNBxMkCCQk8IAmPjVlvWnJ2LDdFL69HaDP3stdc__73_WHEKYkpD7u1yEVnAQJjUXICGUhobEvd2eo-9c4R10ScxawhLEOunJuTQiJKeWXqMNYzOO-SLvobWHqXBWFw6bE07IGu7VQm_IdP5lqaytXf_hnhgeVbdOrKr4ALyw411jAY6u0gbJ2D3iAh6qpTVUqu8dLVcA1uvDGDm5OuYdenkfL4SSYzcfT4WAWZBEVImB5nlKiWKSBCVAMRJLRKFM8ZjGNNFerVcKA51QLlqRKrzTkoLUSPMkV5zTqobujr7_2swFXy41xGRSFKqFqnGyBJSLtU-6lyVGa-Y85C7ncWrPxB0tKDjq5li0_2fKTLVh5ACt3fvT2tKVZbUD_Df6S9ILHo-DbFLD_t7EcDSfztox-AEGLiCg</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>Buchholz, Stefan</creator><creator>Robaei, Daniel</creator><creator>Jacobs, Neil H.</creator><creator>Feneley, Michael P.</creator><general>Blackwell Publishing Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201210</creationdate><title>Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale</title><author>Buchholz, Stefan ; Robaei, Daniel ; Jacobs, Neil H. ; Feneley, Michael P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3155-2ff910a23de25ea2e58c13ca472713d4abb82e4f1d5289adbdefedda548fa4413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>aortic stenosis</topic><topic>Aortic Valve Stenosis - complications</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Arterial Pressure</topic><topic>Bioprosthesis - adverse effects</topic><topic>Echocardiography - methods</topic><topic>False Positive Reactions</topic><topic>Female</topic><topic>Heart Block - diagnostic imaging</topic><topic>Heart Block - etiology</topic><topic>Heart Valve Prosthesis - adverse effects</topic><topic>Humans</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buchholz, Stefan</creatorcontrib><creatorcontrib>Robaei, Daniel</creatorcontrib><creatorcontrib>Jacobs, Neil H.</creatorcontrib><creatorcontrib>Feneley, Michael P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buchholz, Stefan</au><au>Robaei, Daniel</au><au>Jacobs, Neil H.</au><au>Feneley, Michael P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2012-10</date><risdate>2012</risdate><volume>29</volume><issue>9</issue><spage>E218</spage><epage>E220</epage><pages>E218-E220</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>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.
Mini‐
We present a case of elevated pressure gradients across an aortic valve bioprosthesis in the setting of complete heart block. After permanent pacemaker insertion and consideration of the hemodynamic profi le of the specifi c prosthesis and the presence of 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 insertion of a permanent pacemaker.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>22747659</pmid><doi>10.1111/j.1540-8175.2012.01775.x</doi><tpages>3</tpages></addata></record> |
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| subjects | Aged aortic stenosis Aortic Valve Stenosis - complications Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Arterial Pressure Bioprosthesis - adverse effects Echocardiography - methods False Positive Reactions Female Heart Block - diagnostic imaging Heart Block - etiology Heart Valve Prosthesis - adverse effects Humans Reproducibility of Results Sensitivity and Specificity Treatment Outcome |
| title | Pitfalls in Interpreting Bioprosthetic Aortic Valve Pressure Gradients: A Cautionary Tale |
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