Pressure Recovery in Aortic Stenosis

While the diagnosis of aortic stenosis (AS) is relatively straightforward on physical examination and echocardiographic imaging, the determination of severity is often challenging. Assessment of severity assumes the greatest importance when aortic valve replacement is under consideration. In addition to a number of well-known technical frustrations in the Doppler diagnosis, a puzzling and persistent discrepancy between aortic valve gradients obtained by Doppler and those measured at catheterization emerged, further clouding the issue. This discordance led several investigators to the discovery of pressure recovery (PR) of varying degrees in the ascending aorta in AS patients distal to the stenotic valve. PR is often a significant factor in assessing the physiologic burden of AS. The impact of PR must be considered in the comprehensive assessment of AS severity.