Left atrial and pulmonary artery wedge pressure monitoring during balloon mitral valvuloplasty.

ABSTRACT

OBJECTIVE: We tested the accuracy of pulmonary artery wedge (PAW) pressure as a guide to the degree of pulmonary venous hypertension. METHODS: Left atrial (LA) pressure and PAW pressure were analysed before and after balloon mitral valvuloplasty (BMV) in patients with rheumatic mitral stenosis. RESULTS: Correlations between LA and PAW pressures for a wave, v wave and mean pressure were excellent before BMV (r=0.96, r=0.97 and r=0.99 respectively) and after BMV (r=0.98, r=0.98 and r=1.00 respectively). The fall in mean LA pressure (11.3 +/- 7.9 mm Hg) and in mean PAW pressure (11.1 +/- 7.9 mm Hg) also correlated well. Correlation was good both before and after BMV when subgrouping was done based on average pulmonary vascular resistance and average LA mean pressure in each group. CONCLUSIONS: There is good correlation of PAW pressure with LA pressure even in the presence of pulmonary arterial or venous hypertension. It can replace LA pressure monitoring in any clinical setting.