Friday, July 23, 2010

Cath: Pressure wire

The use of pressure wire to evaluate congenital and structural heart disease.
Kempton, TM, et al. Nationwide Children's Hospital, Columbus, OH.
Presented at 2010 PICS meeting, Chicago. Cath Cardiovasc Interv 2010 July;76(1):S4.

Intro: Pressure wire is useful when catheter can not be used due to damping effect, catheter entrapment (e.g. via stent) and hemodynamic instability (e.g. stenosed coarctation, PDA, retrograde arch, etc).

Equipment: 0.014" pressure wire.

Used for the following circumstances:
Hybrid cases - retrograde arch, PDA stent, PA bands, atrial septum (in 30% of procedures)
Vessels jailed by stents (7% of procedures)
Branch PA stenosis (41% of procedures)
Pulmonary vein stenosis (10%)
AS (sub, supra & valvar) (10%)
Prosthetic valve (3%)
MAPCAs (12%)
Others (19%)

Intended information was obtained in all cases. No adverse reactions.
More than one wire was used in 12% due to kinking of wire, baseline shift with inability to calibrate and/or wire dysfunction.

Conclusions:
Complements the interventional armamentarium.
Safe and facilitates measurements when catheter use is inappropriate or contraindicated.
Pressure wire is very sensitive to small kinks.
Operator should be aware of need for frequent calibration due to baseline shift.

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