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The pressure wire as a diagnostic tool in patients with congenital cardiac disease

Published online by Cambridge University Press:  08 February 2011

Tahir Hamid ,
Haider Hadi ,
Bernard Clarke  and
Vaikom Mahadevan
Tahir Hamid
Affiliation:
Manchester Heart Centre, Manchester Royal Infirmary, University of CentralManchester Foundation NHS Trust, Manchester, United Kingdom
Haider Hadi
Affiliation:
Manchester Heart Centre, Manchester Royal Infirmary, University of CentralManchester Foundation NHS Trust, Manchester, United Kingdom
Bernard Clarke
Affiliation:
Manchester Heart Centre, Manchester Royal Infirmary, University of CentralManchester Foundation NHS Trust, Manchester, United Kingdom University of Manchester, Manchester, United Kingdom
Vaikom Mahadevan*
Affiliation:
Manchester Heart Centre, Manchester Royal Infirmary, University of CentralManchester Foundation NHS Trust, Manchester, United Kingdom University of Manchester, Manchester, United Kingdom
*
Correspondence to: Dr V. S. Mahadevan, Consultant Cardiologist and Honorary Lecturer, Manchester Heart Centre, Manchester Royal Infirmary, University of Central Manchester Foundation NHS Trust, Oxford Road, Manchester, M13 9WL, United Kingdom. Tel: 0161 276 8098; Fax: 0161 276 5138; E-mail: [email protected]
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Abstract

The pressure wire has emerged as a useful tool to assess the clinical severity of moderate coronary artery lesions. We report a novel use of the pressure wire in adult patients with complex congenital cardiac disease in whom it was used in assessing pressures beyond the stenosis in the distal pulmonary artery, aorto-pulmonary collaterals, and across prosthetic tricuspid valves, where conventional catheters were unable to reach. We used this in three of our patients for assessment of pulmonary artery pressures and in two patients for assessment of pressures across a prosthetic St Jude® valve. Out of the three patients referred for assessment, only two had significantly raised distal pulmonary pressures enabling them to receive appropriate therapy. Out of the two patients with a prosthetic tricuspid valve, only one required surgery based on this assessment. We describe a novel use of the pressure wire in the functional assessment of adults with congenital cardiac disease in whom conventional catheter techniques may not be able to provide adequate data. It can be a guide to provide appropriate therapy and avoid unnecessary interventions in this patient group.

Keywords

Pressure wirepulmonary artery hypertensioncongenital cardiac disease
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 3 , June 2011 , pp. 317 - 320
Copyright
Copyright © Cambridge University Press 2011

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References

1. Topol, EJ, Nissen, SE. Our preoccupation with coronary luminology: the dissociation between clinical and angiographic findings in ischemic heart disease. Circulation 1995; 92: 2333–2342.Google Scholar
2. Kern, MJ, De Bruyne, B, Pijls, NH. From research to clinical practice: current role of intracoronary physiologically based decision making in the cardiac catheterization laboratory. J Am Coll Cardiol 1997; 30: 613–620.CrossRefGoogle ScholarPubMed
3. Pijls, NH, Van Son, JA, Kirkeeide, RL, De Bruyne, B, Gould, KL. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation 1993; 87: 1354–1367.Google Scholar
4. Pijls, NH, Van Gelder, B, Van der Voort, P, et al. Fractional flow reserve: a useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow. Circulation 1995; 92: 3183–3193.Google Scholar
5. Pijls, NH, De Bruyne, B, Peels, K, et al. Measurement of fractional flow reserve to assess the functional severity of coronary artery stenoses. N Engl J Med 1996; 334: 1703–1708.Google Scholar
6. Edwards, RJ, Al-Bustami, M, Ilsley, CD. A novel method of assessing Starr-Edwards aortic valve stenosis. Heart 2004; 90: 1479–1480.Google Scholar
7. Bae, JH, Lerman, A, Yang, E, Rihal, C. Feasibility of a pressure wire and single arterial puncture for assessing aortic valve area in patients with aortic stenosis. J Invasive Cardiol 2006; 18: 359–362.Google ScholarPubMed
8. Bertog, SC, Smith, A, Panetta, CJ. Feasibility assessment of aortic valve area in patients with aortic stenosis using a pressure wire through a 4 French system and single femoral arterial access. J Invasive Cardiol 2005; 17: E24–E26.Google ScholarPubMed
9. Hoffman, JI, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.Google Scholar
10. Rubin, LJ, Badesch, DB, Barst, RJ, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med 2002; 346: 896–903.CrossRefGoogle ScholarPubMed
11. Cho, JM, Puga, FJ, Danielson, GK, et al. Early and long-term results of the surgical treatment of tetralogy of Fallot with pulmonary atresia, with or without major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg 2002; 124: 70–81.Google Scholar