Understanding hemodynamic waveforms during balloon valvuloplasty is crucial for identifying complications like valvular insufficiency and artifacts from stiff guidewires.
Distinguishes true severe insufficiency from guidewire artifacts during valvuloplasty; leaves open prospective validation of hemodynamic monitoring.
The hemodynamic findings of aortic, mitral and pulmonary balloon valvuloplasty serve to identify classical valvular lesions and their responses to graded or abrupt catheter dilation techniques. The production of mild insufficiency after valve dilation is generally well tolerated. Severe valvular insufficiency produces the expected hemodynamic alterations, but acute decompensation may be witnessed over brief periods of time. The use of extra stiff guidewires across dilated valves, especially the aortic valve, may also produce an exaggerated hemodynamic picture of insufficiency. Although gradients may be reduced, the effect of valve dilation on aortic valve area is generally small. A discussion of factors influencing valve area calculations will be the subject of a future "Rounds."
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Deligönül et al. (1991) studied this question.
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