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Review
. 2023 May 11;13(10):1698.
doi: 10.3390/diagnostics13101698.

Is There Still a Role for Invasive Assessment of Aortic Gradient?

Domenico Angellotti  1 , Maddalena Immobile Molaro  1 , Fiorenzo Simonetti  1 , Federica Ilardi  1 , Domenico Simone Castiello  1 , Andrea Mariani  1 , Rachele Manzo  1 , Marisa Avvedimento  1 , Attilio Leone  1 , Dalila Nappa  1 , Raffaele Piccolo  1 , Maria Angela Losi  1 , Anna Franzone  1 , Giovanni Esposito  1
Affiliations
Review

Is There Still a Role for Invasive Assessment of Aortic Gradient?

Domenico Angellotti et al. Diagnostics (Basel). .

Abstract

Advances in technology and imaging have expanded the range of tools for diagnosing aortic stenosis (AS). The accurate assessment of aortic valve area and mean pressure gradient is crucial to determine which patients are appropriate candidates for aortic valve replacement. Nowadays, these values can be obtained noninvasively or invasively, with similar results. Contrariwise, in the past, cardiac catheterization played a major role in the evaluation of AS severity. In this review, we will discuss the historical role of the invasive assessment of AS. Moreover, we will specifically focus on tips and tricks for properly performing cardiac catheterization in patients with AS. We will also elucidate the role of invasive methods in current clinical practice and their additional value to the information provided through non-invasive techniques.

Keywords: aortic stenosis; cardiac catheterization; gradient; invasive.

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Conflict of interest statement

Piccolo reports personal fees from Abbott Vascular, Biotronik, Terumo, Amgen, Boehringer Ingelheim and Daiichi-Sankyo, outside the submitted work. Esposito reports personal fees from Abbott Vascular, Amgen, Boehringer Ingelheim, Edwards Lifesciences, Terumo and Sanofi, outside the submitted work and research grants to the institution from Alvimedica, Boston Scientific and Medtronic. The other authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Timeline of the role of invasive assessment in AS diagnosis.
Figure 2
Figure 2
Cardiac catheterization (simultaneous pressure recording) in patients with normal aortic gradient, high-gradient and low-flow low-gradient AS.
Figure 3
Figure 3
Invasive tools to estimate transaortic gradient. Ao: aorta.
See this image and copyright information in PMC

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