Counterintuitively Crossing a Critically Stenosed Aortic Valve is a Diastolic Phenomenon

Crossing of a critically stenosed aortic valve is a pivotal step during diagnostic cardiac catheterization to measure the transvalvular gradient, especially in patients with discordant clinical and echocardiographic findings and also during transcatheter aortic valve replacement procedures. However, there are no data in the literature indicating whether aortic valve crossing typically occurs during systole or diastole. We hypothesize that aortic valve crossing is a diastolic phenomenon and describe our technique for crossing critically stenosed aortic valves.