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Assessment of apical radial pulse

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Updated: Jun 17, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

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Transmitral Gradient Assessment Using a Radial Coronary Catheter and Pressure Wire: The First Clinical Report.

Eric S Rothstein¹, Augustin J DeLago¹, Amit P Amin¹

¹Dartmouth-Hitchcock Medical Center Heart and Vascular Center, Geisel School of Medicine, Lebanon, New Hampshire.

Journal of the Society for Cardiovascular Angiography & Interventions

|August 12, 2024

Summary

Single radial artery access allows direct transmitral gradient measurement. This novel technique enables simultaneous left atrial and left ventricular hemodynamic assessment via retrograde catheterization.

Keywords:

Hemodynamics Left Atrial Pressure Mitral Stenosis

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Area of Science:

Cardiology
Interventional Cardiology
Hemodynamics

Background:

Accurate assessment of transmitral gradient is crucial for diagnosing mitral valve disease.
Current methods may require transseptal puncture, carrying specific risks.
A less invasive approach is desirable for hemodynamic assessment.

Observation:

A novel technique utilizing a single radial artery access was developed.
A TIG coronary catheter was advanced retrograde from the radial artery into the left atrium.
A coronary pressure wire was then advanced into the left atrium and maintained in position.

Findings:

The TIG catheter was subsequently withdrawn into the left ventricle.
This maneuver allowed for simultaneous measurement of left atrial and left ventricular pressures.
Direct transmitral gradient measurement was feasible using this approach.

Implications:

This technique offers a potentially safer alternative to transseptal puncture for hemodynamic assessment.
It enables simultaneous left atrial and left ventricular pressure monitoring from a single arterial access.
This method may improve the diagnostic accuracy and safety of evaluating mitral valve function.