Clinical meaning
The clinician interprets cardiac catheterization data for clinical decision-making, selects procedural strategies, and manages complex post-PCI care. Hemodynamic data interpretation includes: LVEDP (normal 5-12; above 15 suggests diastolic dysfunction; above 20 suggests decompensated HF); aortic valve gradient (mean gradient above 40 mmHg with AVA below 1.0 cm2 indicates severe aortic stenosis); mitral valve gradient (mean gradient above 10 mmHg indicates severe mitral stenosis); Qp/Qs ratio (pulmonary-to-systemic flow ratio above 1.5 indicates hemodynamically significant left-to-right shunt, as in ASD or VSD). Angiographic stenosis severity is graded by percent luminal narrowing, but functional significance requires FFR or iFR assessment for intermediate lesions (40-70%). PCI decision-making involves assessing the SYNTAX score (anatomical complexity: low 0-22, intermediate 23-32, high 33+; high SYNTAX favors CABG over PCI for multi-vessel disease). The clinician manages DAPT duration using the DAPT score (considers age, diabetes, smoking, prior MI/PCI, stent diameter/type, CHF, vein graft stenting; score above 2 favors extended DAPT, below 2 favors shortened DAPT). The clinician also manages patients on chronic anticoagulation who require PCI, using the least thrombogenic regimen possible (shortest duration of triple therapy with transition to dual pathway therapy).