Simultaneous Right Ventricular to Pulmonary Artery Pressure Gradient Measurement Using a Single Venous Access Technique

Abstract

Purpose The pullback gradient technique is commonly used to evaluate pulmonic stenosis; however, it only represents a one-time measurement of valvular stenosis. Instead, simultaneous peak-to-peak gradients account for the data variability being best suited to discern the severity of the stenosis, but requires two different venous accesses. Here, we demonstrate the feasibility and high fidelity hemodynamic tracings of a new technique for evaluation of pulmonary valve stenosis by using a single venous access. Methods We present a patient scenario suggesting pulmonic stenosis. Given the possible therapeutic intervention, we decided to use a single large bore (8-French) venous access. Results Simultaneous peak-to-peak gradients were obtained from high fidelity hemodynamic tracings measured using two small-size catheters located in the right ventricle (RV) and pulmonary artery (PA), respectively. The procedure had no complications. Conclusions We present a technique using single venous access for simultaneous RV and PA pressure measurement that is easy to perform and, importantly, it may be safer than exposing the patient to multiple venous accesses.