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Echocardiographic Evaluation of Aortic Stenosis

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Multimodality Imaging for Transcatheter Aortic Valve Replacement

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Abstract

Echocardiography is a definitive tool for the assessment of aortic stenosis (AS). Echocardiographic assessment should include morphology of the aortic valve and related structures as well as a functional assessment of aortic stenosis severity. Functional assessment includes peak velocity of the AS jet, mean pressure gradient, and aortic valve area. Accurate assessment and reporting of aortic stenosis require a commitment to technical excellence as well as a sophisticated understanding of the limitations of functional parameters and potential for measurement errors. Echocardiograhers should provide an overall determination of aortic stenosis severity, determine suitability for treatment with transcatheter heart valve techniques, and resolve discrepant measurements whenever possible. Three-dimensional (3D) echo has an increasing role, especially in the transcutaneous heart valve context. Finally, AS needs to be viewed in the context of the function of the heart as a whole taking into account systolic and diastolic function, cardiac remodeling, non-aortic valvular heart disease, and the influence of associated cardiac conditions.

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Abbreviations

AF:

Atrial fibrillation

AR:

Aortic regurgitation

AS:

Aortic stenosis

AVA:

Aortic valve area

BSA:

Body surface area

CW:

Continuous wave

EOA:

Effective orifice area

LVOT:

Left ventricular outflow tract

MR:

Mitral regurgitation

PSAS:

Pseudosevere aortic stenosis

PW:

Pulse wave

3D:

Three dimensional

TEE:

Transesophageal echo

THV:

Transcatheter heart valve

TSAS:

Truly severe aortic stenosis

VTI:

Velocity-time integral

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Authors and Affiliations

  1. Department of Cardiology, St. Paul’s Hospital, Room 474 Burrard Building, 1081 Burrard St, Vancouver, BC, V6Z1Y6, Canada

    Robert R. Moss MB, BS

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  1. Robert R. Moss MB, BS
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Correspondence to Robert R. Moss MB, BS .

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Editors and Affiliations

  1. NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA

    James K. Min

  2. Departments of Imaging and Medicine, David Geffen UCLA School of Medicine, Cedars-Sinai Medical Center Cedars-Sinai Heart Institute, Los Angeles, California, USA

    Daniel S. Berman

  3. Department of Cardiology, St. Paul’s Hospital, University of British Columbia Department of Radiology, Vancouver, British Columbia, Canada

    Jonathon Leipsic

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Moss, R.R. (2014). Echocardiographic Evaluation of Aortic Stenosis. In: Min, J., Berman, D., Leipsic, J. (eds) Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer, London. https://doi.org/10.1007/978-1-4471-2798-7_12

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  • DOI: https://doi.org/10.1007/978-1-4471-2798-7_12

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