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Echo features of aortic stenosis

Echo features of aortic stenosis. Sayed Abou Elsoud ,MD SBCC. Agenda. Assessement of valve morphology Quantification of stenosis severity Prognosis provided by Echo. Normal aortic valve. Tricuspid (three leaflets ) valve Three comissures Normal AVA = 3-4CM2

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Echo features of aortic stenosis

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  1. Echo features of aortic stenosis SayedAbouElsoud ,MD SBCC

  2. Agenda • Assessement of valve morphology • Quantification of stenosis severity • Prognosis provided by Echo

  3. Normal aortic valve • Tricuspid (three leaflets ) valve • Threecomissures • Normal AVA =3-4CM2 • Laminar transvalvular flow • Peak velocity <2m2 /s

  4. Lambl’s excrescence

  5. Assessement of valve morphology • Site of LV outflow obstruction (types of AS) • Valvular ( most common) • Subvalvular • Fixed • Discrete membrane • Muscular band • Dynamic • Hypertophic obstructive CM • supravavular

  6. Assessement of valve morphology • Valvular AS aetiology • Calcific (degenerative) • Congenital • rheumatic

  7. Ant /post configurationfusion of RT&LT commissures

  8. Bicuspid AV LT/RT configurationfusion of RT&NONCOR commissures

  9. Subaortic membrane LAX view

  10. Subaortic membrane5 CH view

  11. HOCM

  12. Supravalvaular AS

  13. shone’s syndrome

  14. shone’s syndrome

  15. shone’s syndrome

  16. shone’s syndrome coarctation

  17. Post operative ROSS procedure

  18. Aetiology of AS

  19. Quantification of stenosis severity

  20. AV velocity & gradient

  21. Mild AS

  22. Moderate AS LAX view

  23. Moderate AS5ch view

  24. Moderate AS • AVA = 3.14x1x1 x 33 / 73 = 1.4 cm2 • Dimensionless index = 0.47 • MAX G =58 mmhg • MEAN G = 30 mmhg

  25. Sever ASSAX view

  26. Sever AS 5ch view

  27. Sever AS

  28. PEAK G= 127 MMHG • MEAN G= 76 MMHG • DIMENSIONLESS INDEX = 15% • AREA = 0.8 CM2

  29. Aortic valve area

  30. AVA X VTI AS = CSA LVOT XVTILVOT ( continuity equation)

  31. AV area ( continuity equation)

  32. AVA planimetry

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