None.

We appreciate the insightful comments by Drs Jenni and Martin regarding our recent publication.1 We agree with them that the deter-mination of serial gradients using conventional Doppler data is prob-lematic. The derivation used for Figure 3 results in the generation of negative gradients, which are nonphysiological, supporting the conclusions that we and Drs Jenni and Martin have presented. Drs Jenni and Martin correctly pointed out that the velocity V2 in our article was not corrected for pressure recovery. As they sug-gested, we have now applied the equation derived by Garcia et al2 to the data derived from our patient to correct for energy loss. In this equation, energy loss (EL), which represents the actual work-load caused by the stenosis, EL=4V2VC(1−EOA/AA),2 accounts for both static and dynamic pressure changes across the system and was derived by combining the Bernoulli and linear momentum equations. We used the following assumptions: (1) AA represente