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Clinicians must exclude artifacts in LA/LV pressure tracings before mitral gradient-guided decisions; leaves open standardized validation protocols in prospective studies.
The mitral valve gradient is dependent on the precise measurement of left atrial (or pulmonary capillary wedge) and left ventricular pressures. Artifacts involving either pressure measurement will produce inaccuracies which may have clinical significance. Several methods and formulas using both invasive and noninvasive techniques should verify clinical findings and confirm the severity of mitral valve disease prior to definite therapy. The changes in mitral valve gradients after balloon catheter valvuloplasty will be discussed in part II of this hemodynamic rounds.
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Kern et al. (1992) studied this question.
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