Echocardiogram for Aortic Valve Stenosis, the Complex Interplay between Flow and Gradient and Insight into Stress Echocardiography and Transoesophageal Echo for Transcatheter Aortic Valve Implantation (TAVI)
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 7
Abstract
Aortic valve stenosis (AS) is a relatively frequent pathology in the elderly and management is mainly dependent on the degree of stenosis and the potential presence of comorbidities. Transthoracic echocardiography (TTE) is the basic initial test for aortic valve imaging, yielding valuable measurements of aortic valve area, peak velocity, mean and peak gradients and dimensionless velocity index. TTE allows to classify the type of AS, as high gradient/normal flow (HG/NF), low gradient/normal flow (LG/NF), high gradient/low flow (HG/LF) and low gradient/low flow (LG/LF); the latter is also subdivided into regular or paradoxical LG/LF according to the value of the ejection fraction (EF). Transoesophageal echocardiography (TOE) has an added value compared to TTE for detailed anatomical visualization of the aortic valve and adjacent structures, also it is particularly useful as a perprocedural test during transcatheter aortic valve implantation (TAVI). Moreover, stress echocardiography (SE) is useful in cases where accurate assessment of the degree of stenosis is challenging, especially in LF/LG AS. In summary, appropriate assessment of AS is essential in order to guide decision making and echocardiography is the gold standard test for this purpose. Keywords:Aortic valve stenosis (AS), Transthoracic echocardiography (TTE), echocardiography
Authors and Affiliations
Karen Dimitrova, Antoine Kossaify
Keywords
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