• Issue

    Catheterization and Cardiovascular Interventions: Volume 94, Issue 2

    i-vii, 171-313, E54-E95
    August 1, 2019

ISSUE INFORMATION - COPYRIGHT

Free Access

Issue Information - Copyright

  • Page: i
  • First Published: 04 August 2019

ISSUE INFORMATION - EDITORIAL BOARD

Free Access

Issue Information - Editorial Board

  • Page: iii
  • First Published: 04 August 2019

ISSUE INFORMATION - TOC

Free Access

Issue Information - TOC

  • Pages: v-vii
  • First Published: 04 August 2019

PRESIDENT'S PAGE

CORONARY ARTERY DISEASE

Original Studies

VALVULAR AND STRUCTURAL HEART DISEASES

Hemodynamic Rounds

Mixed aortic valve disease treated with transcatheter aortic valve replacement in a high risk patient presenting with acute decompensated heart failure

  • Pages: 296-300
  • First Published: 10 April 2019
Key points

  • Mixed aortic valve disease refers to the combination of aortic regurgitation (AR) and aortic stenosis (AS).
  • Common etiologies include bicuspid aortic valve, rheumatic heart disease, and endocarditis superimposed upon a stenotic aortic valve.
  • Hemodynamic findings of mixed aortic valve disease demonstrate findings of both AR and AS with a delayed aortic upstroke in the setting of other hemodynamic features of AR (wide pulse pressure, low aortic end diastolic pressure)
  • Assessment of left ventricular end diastolic pressure (LVEDP) can be useful to determine whether the volume overload of AR is well-tolerated by the left ventricle. A normal LVEDP suggests the volume overload is well tolerated and chronic in duration. In contrast, an elevated LVEDP suggests that the volume overload is not well-tolerated and is more acute in duration.
  • Patients with long-standing, chronic AR may develop a sudden worsening either from a superimposed process or when the left ventricle is no longer able to further dilate to accommodate the regurgitant volume. In this setting, the hemodynamics may appear similar to acute AR.
  • Transcatheter aortic valve replacement (TAVR) represents a new treatment option for patients with mixed aortic valve disease deemed high risk or nonoperable for surgical aortic valve replacement.

CORONARY ARTERY DISEASE (E-only Article)

Original Studies