Evaluation of Peak Pressure Gradients in Patients after Melody Valve Implantation: A Comparison of Cardiac Catheterization and Doppler Echocardiography

Objectives The aim of this study was to determine and quantify the relationship between Doppler echocardiography and cardiac catheterization measurements of the peak right ventricle‐pulmonary artery (RV‐PA) pressure gradient in patients within 24 hours of Melody valve implantation for treatment of a dysfunctional RV outflow tract (RVOT) conduit or bioprosthetic valve (BPV). Background Patients with a dysfunctional RVOT conduit or BPV are now routinely treated percutaneously with implantation of a Melody valve. However, often the postimplantation catheter measurements of the RV‐PA peak gradient do not match the postimplant echo‐derived gradients obtained after completion of the procedure. Importantly, these echo gradients are commonly used to monitor patients after implantation over time. Methods Medical records of 42 patients with Melody valve implantation were reviewed (men: 25/42; mean age: 22.4 ± 11.2 years; RVOT conduit: 23/42; BPV: 18/42; pulmonic stenosis: 6/42, pulmonic regurgitation: 3/42, both: 33/42). Results The postimplantation RV‐PA peak gradient measured by Doppler echocardiography (within 24 hours of valve implantation) was significantly higher than the measurements acquired by catheterization immediately following implantation (24.2 ± 16.3 mmHg vs. 11.6 ± 8.5 mmHg, P