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. 2021 Jun 16;3(6):853–858. doi: 10.1016/j.jaccas.2021.03.028

Figure 2.

Figure 2

Figure 2

Hemodynamic Tracings

(A) Hemodynamic tracing of the left ventricle-aorta (LV-AO) at baseline before transcatheter aortic valve replacement (TAVR) and placing the pigtail catheter just below the valve to avoid contamination with the left ventricular outflow tract (LVOT) gradient. This tracing confirms diagnosis of severe low-flow low-gradient aortic stenosis. (B) Hemodynamic tracing of the LV-AO after TAVR and placing the pigtail catheter just below the valve to avoid contamination with the LVOT gradient showing successful TAVR and elimination of the severe aortic stenosis gradient. (C) Hemodynamic tracing of the LV-AO placing the pigtail catheter inside the left ventricular cavity showing LVOT obstruction (LVOTO). The fifth measurement demonstrates the Brockenbrough sign with increased gradient after a premature ventricular contraction. (D) Pull back of the pigtail catheter from the inside the left ventricular cavity to just below the aortic valve confirming severe LVOTO. (E) Hemodynamic tracing of the LV-AO after alcohol septal ablation (ASA) showing successful elimination of the LVOTO and no gradient. Also showing a negative Brockenbrough sign (which was positive before the ASA).