Discrepancies between direct catheter and echocardiography-based values in aortic stenosis

Objectives The goal of this article is to examine the correlation of catheter (cath) based and echocardiographic assessment of aortic stenosis (AS) in a community‐based academic hospital setting, particularly in the degree that decision to refer for surgery is altered. Background Current guidelines discourage AS evaluation by invasive pressure measurement if echocardiography (echo) is adequate, but several studies show sizable differences between echo and cardiac catheterization lab (CCL) measurements. We examine this correlation using high quality CCL techniques. Methods Sequential patients with suspected AS by echo (n = 40) aged 61–94 underwent catheterization with pressure gradients via left ventricular pressure wire and ascending aorta catheter. The echos leading to the catheterization were independently reviewed by an expert panel to assess the quality of community‐based readings. Results CCL changed assessment of severity of aortic valve area (AVA) by more than 0.3 cm2 in 25% and 0.5 cm2 in 8%. Values changed to over or under the surgical threshold of AVA