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Use of the Miniature Pressure-Wire Manometric System in Congenital and Acquired Structural Heart Diseases

Background:

Historically, intravascular pressure recording has contributed to the development of interventional cardiology. Although new imaging resources have gained much attention, accurate intravascular pressure measurement remains essential for the diagnosis and evaluation of interventional therapy methods. We describe the use of the miniature manometric system (pressure-wire) to obtain pressure curves in congenital and acquired structural heart diseases.

Methods:

The Radi Analyzer® Xpress (St. Jude Medical Inc., St. Paul, MN, USA) and PressureWire®Certus systems were used in procedures with 5 F catheters under eneral anesthesia and ventilatory support in children. Manometric tracings were obtained simultaneously from pressure-wire and the 5 F catheter in patients whose therapy strategies were dependent on the analysis of intravascular pressures, and in whom was not possible to obtain them accurately by conventional methods.

Results:

Pressure-wire was used to obtain pulmonary intravascular pressures in patients with systemic-pulmonary collaterals with or without angiographically detected stenosis, and with different structural heart diseases, in the evaluation of pulmonary branch stenosis, in the localization of surgical conduit stenosis (e.g. after Rastelli surgery), surgical shunts (such as Blalock-Taussig) and in the preoperative evaluation of cavo-pulmonary shunts. The procedure was performed safely, and manometric tracings were obtained with an adequate quality.

Conclusions:

The miniature manometric system is well accepted as a complementary diagnostic modality for the functional assessment of coronary lesions in interventional cardiology. It is also a complementary diagnostic method in different structural, congenital and acquired heart diseases.

Heart defects, congenital; Cardiac catheterization; Hemodynamics


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