Right heart catheterisation may be cautiously performed through a mechanical valve prosthesis in the tricuspid position.

Right heart catheterisation (RHC) may be performed through a mechanical valve prosthesis in the tricuspid position using a partially inflated pulmonary artery flotation catheter. Preprocedural preparation should include an ex vivo trial with an identical valve prosthesis and the type of catheter to be used for the procedure. The operator should expect immediate unloading of the right ventricle due to catheter-associated tricuspid regurgitation, but it is possible to estimate pulmonary vascular resistance using the Fick principle. The risk of catheter entrapment or damage to the prosthetic leaflets during the procedure is likely to be low. This risk may be acceptable to the clinician and the patient if pulmonary vascular resistance must be measured in order to determine eligibility for heart transplantation. 2016 BMJ Publishing Group Ltd.