A novel method of assessing Starr-Edwards aortic valve stenosis.

C atheter assessment of Starr-Edwards prosthetic aortic valve stenosis requires simultaneous recording of left ventricular (LV) and aortic pressures. Passage of conventional Dacron catheters across mechanical valves can damage the mechanism and induce valvar incompetence. The alternative Bockenbrough procedure requires atrial septal puncture with potential lethal complications. The availability of a low profile, floppy tipped, 0.014 inch guidewire mounted pressure sensor (PressureWire 4, RADI Medical Systems, Uppsala, Sweden) provides a novel means of crossing this type of valve. The use of fine bore pressure wires may be less likely to disturb the ball cage mechanism than larger fluid filled catheters, and may provide a safe and reproducible method of assessing Starr-Edwards aortic valve stenosis. However, the use of the pressure wire in assessing bileaflet or tilting disc prosthetic valves may be more problematic.