Single Radial Access Simultaneous Left Ventricular and Ascending Aortic Pressure for the Evaluation of Aortic Stenosis: The “Double-Barrel” Technique

The use of simultaneous left ventricular and ascending aortic pressure tracings by cardiac catheterization is the gold standard of care for accurate hemodynamic assessment of aortic stenosis severity in patients with equivocal echocardiogram. We describe the first-in-man single radial access “double-barrel” technique for the evaluation of aortic stenosis. A 7-Fr Glidesheath Slender hydrophilic-coated introducer sheath (Terumo) was placed in the right radial artery. Two 4-Fr pigtails, 1 in the left ventricle and 1 in the ascending aorta, were advanced through the single sheath. The single radial access “double-barrel” technique is a simple way to accurately evaluate patients with aortic stenosis, avoiding multiple access sites or femoral access.