![Calculation of R.Volume and R.fraction
• SV=CSAxVTI
• R.Volume=SV[lvot]-SV[mv]
• RF=R.Volume/SV[lvot]
• ERO=R.Volume/VTI[ARjet]
• R.V>60ml,RF>50%,ERO>0.3cm² indicate severe AR](https://image.slidesharecdn.com/echoassessmentofaorticvalvedisese-171002130410/85/Echo-assessment-of-aortic-valve-disease-63-320.jpg)
Echo assessment of aortic valve disease
- 1. ECHOCARDIOGRAPHIC ASSESMENT OF AORTIC VALVE DISEASES
- 2. Aortic stenosis: Classification based on location Valvular- most common type. Subvalvular. Supravalvular.
- 3. Valvular Aortic Stenosis: Etiology
- 7. Congenital Anomalies Of AV valve
- 8. Calcific Aortic Stenosis of trileaflet valve
- 17. Doppler assessment of AS (EAE/ASE Recommendations for Clinical Practice 2009).
- 18. Classification of AS severity (based on 2014 AHA/ACC Valvular heart disease guideline)
- 19. Peak transvalvular velocity measurement
- 26. Sources of error for pressure gradient calculations
- 27. Sources of error for pressure gradient calculations
- 28. Aortic valve area Continuity equation
- 30. Aortic valve area Continuity equation
- 32. Advantage of the Continuity Equation over Peak velocity Pressure gradient
- 33. Pitfalls of the Continuity Equation
- 34. Pitfalls of the Continuity Equation
- 36. Low Dose Dobutamine Stress Echo- Protocol
- 37. Low Dose Dobutamine Stress Echo
- 39. Effects of concurrent conditions on assessment of severity
- 40. Effect of LVH
- 41. Effect of LVH
- 43. Effect of Aortic Regurgitation
- 44. Effect of Mitral valve disease
- 45. M Mode- Aortic Stenosis DeMaria A N et al. Circulation.Suppl II. 58:232,1978
- 46. ECHOCARDIOGRAPHIC ASSESSMENT OF AORTIC REGURGITATION
- 47. MILD MODERATE SEVERE Jet width/LVOT diameter <25% >/=65% Vena contracta <3mm >/=6mm Jet area/LVOT area <5% >60% PHT >500 ms </= 250ms Holodiastolic flow reversal present
- 48. MILD MODERATE SEVERE Reg vol < 30 ml >/= 60 ml Reg fraction < 30 % >/= 50% ERO < 0.1 cm2 >/= 0.3 cm2 Mitral inflow restriction Present
- 49. AR – VC, Jet width / Lvot width
- 50. • Regurgitant jet height measured as maximal diameter of regurgitant jet just below AV,PLAX view • LVOT diameter in end diastole
- 51. Regurgitant jet width/LVOT diameter ratio greater than or equal to 60 percent
- 52. Vena contracta greater than 6 mm
- 53. AR – Jet area / Lvot area
- 54. • Regurgitant jet area measured from PSAX view at level of LVOT • LVOA measured at end diastole at same site • Ratio calculated
- 56. AR – Pressure Half Time
- 57. • Regurgitant doppler signal is a function of pressure gradient between aorta and LV • Mild AR –small increase in LVEDP-gradual decline and flat deceleration slope • Severe AR –LVEDP rises rapidly-rapid decline
- 60. • Suprasternal window-descending aortic flow profile • Short period of low velocity flow reversal-normal • Pan diastolic flow reversal with end diastolic velocity>20cm/s
- 63. Calculation of R.Volume and R.fraction • SV=CSAxVTI • R.Volume=SV[lvot]-SV[mv] • RF=R.Volume/SV[lvot] • ERO=R.Volume/VTI[ARjet] • R.V>60ml,RF>50%,ERO>0.3cm² indicate severe AR
- 65. Restrictive mitral flow pattern
- 69. Extent of jet
- 70. Signal intensity
- 71. Classification of AS severity (based on 2014 AHA/ACC Valvular heart disease guideline)
- 72. SEVERITY • 1. Regurgitant jet width/LVOT diameter ratio greater than or equal to 60 percent • 2. Vena contracta greater than 6 mm • 3. Regurgitant jet area/LVOT area ratio greater than or equal to 60 percent • 4. Aortic regurgitation pressure half-time less than or equal to 250 ms • 5. Holodiastolic flow reversal in the descending thoracic or abdominal aorta • 6. Regurgitant volume greater than or equal to 60 mL • 7. Regurgitant fraction greater than or equal to 50 percent • 8. Effective regurgitant orifice greater than or equal to 0.30cm2 • 9. Restrictive mitral flow pattern (usually in acute setting)
- 73. THANK YOU..