Aortic stenosis cardiac catheterization

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2]; Abdul-Rahman Arabi, M.D. [3]; Keri Shafer, M.D. [4]; Priyamvada Singh, MBBS [[5]]

Assistant Editor-In-Chief: Kristin Feeney, B.S. [[6]]

Overview

Cardiac catheterization, such as angiography, may be used as a diagnostic tool in the evaluation of aortic stenosis. Angiographic findings associated with aortic stenosis include left ventricular hypertrophy and heart block.

Cardiac catheterization

Simultaneous left ventricular and aortic pressure tracings demonstrate a pressure gradient between the left ventricle and aorta, suggesting aortic stenosis. The left ventricle generates higher pressures than what is transmitted to the aorta. The pressure gradient, caused by aortic stenosis, is represented by the green shaded area. (AO = ascending aorta; LV = left ventricle; ECG = electrocardiogram.)

The heart may be catheterized to directly measure the pressure on both sides of the aortic valve. The pressure gradient may be used as a decision point for treatment. Catheterization is accurate for moderate velocity stenosis, while Doppler echo is more accurate at faster velocities.