ABSTRACT
This chapter focuses on the modern use of invasive hemodynamics in the assessment of valvular heart disease (VHD). Normal cardiac valves permit unidirectional circulatory flow at low resistance with equal pressure on both sides of an open valve. The hemodynamic determination of mitral valve area (MVA) in mitral stenosis (MS) employs the same principles as the hemodynamic determination of aortic stenosis (AS) severity. It requires an accurate transmitral valvular gradient, an accurate cardiac output (CO), and an accurate formula relating the two. The chapter describes some of the classic features of the hemodynamics of aortic regurgitation (AR). Aortography has the potential to add significant data in the evaluation of the patient with AR. Ventriculography has a similar advantage in visualizing mitral regurgitation (MR) as aortography does in AR. More precise assessment of the amount of AR or MR can be made by measuring the regurgitant volume (RV), which is the difference between total and forward stroke volume (SVf).
