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Direct LV puncture through the LV apex via the fifth intercostal space using echo-guided needle positioning is applied for transapical aortic valve replacement. This method carries significant risk of bleeding and potential coronary artery damage.
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Measurement of the transmitral gradient by cardiac catheterization is frequently made with a simultaneous pulmonary artery wedge pressure (PAWP) and left ventricular (LV) pressure. However, as a result of the delay in transmission of the change in pressure contour and a phase shift, the gradient using a pulmonary artery wedge pressure will .
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