The measurement of pulmonic valve area by angiocardiographic and hemodynamic methods

Abstract

The validity of angiocardiographic measurements in assessing the severity of pulmonic valve stenosis was determined. The pulmonic valve orifice area was measured in the lateral projection on cineangiocardiographic films in 24 patients with valvar pulmonic stenosis. The valve orifice area was also obtained in the same patients by the Gorlin and Bache formulae. The right ventricular output value required for insertion in these formulae was obtained by angiocardiographic right ventricular volume measurement and by the Fick method. The correlation between the directly measured valve orifice area and the area calculated using the Fick principle and the Bache formula was 0.80. The substitution of angiocardiographically measured right ventricular stroke volume for the Fick value gave a correlation of 0.82. The results support validity of employing direct angiocardiographic measurements of pulmonic valve orifice area and angiocardiographic right ventricular volume measurements for quantitative assessment of the severity of pulmonic valve stenosis. The angiocardiographic methods thus represent an alternative to the Fick technique which can be used in conditions where the Fick method cannot be expected to give valid results.

Assessment of the orifice diameter by a multigated pulsed Doppler system in children with congenital semilunar valve stenosis.

“…The orifice area can also be derived from the width of a jet of contrast.4 This angiocardiographic orifice area accorded with the haemodynamically calculated orifice area, when the area of the stenosis was assumed to be circular. 4 In eight out of nine patients the valve orifice calculated from the angiocardiographic jet diameter was smaller than the diameter measured during operation. 5 The introduction of echocardiography, especially cross sectional and Doppler techniques, has improved the potential for the non-invasive prediction of the severity of valve stenosis.6 Pulsed and continuous wave Doppler systems allow the gradient across a stenotic valve to be calculated from the Bernoulli equation.…”