Direct Measurement of Transmitral Valve Pressure during Transradial Left Heart Catheterization Using a Dual Lumen Catheter

Echocardiography remains the primary diagnostic modality for evaluation of mitral stenosis, yet invasive testing can provide more precise hemodynamic measurements in borderline or symptomatic cases. Historically, direct left atrial pressure measurement required a transseptal approach, which carries procedural risk. Pulmonary capillary wedge pressure subsequently became an accepted surrogate but may overestimate true left atrial pressure, particularly in critically ill patients. In this report, we describe the use of a Langston® dual-lumen catheter during routine transradial left heart catheterization to directly measure transmitral gradient and calculate mitral valve area, offering a potentially safer and practical alternative for hemodynamic assessment in selected patients.