Direct Assessment of Aortic Valvular Stenosis by Cross-Sectional Echocardiography

Abstract

Measurement of aortic valve stenosis using M-mode echocardiography has been attempted by indirect methods, such as the measurement of left ventricular wall thickness to left ventricular cavity dimension ratio (1) or by defining the relationship between aortic cusp separation and the posterior movement of the aortic root (2). The severity of stenosis has been assessed more directly by measuring systolic cusp separation (3). This however, may be misleading as a stenosed valve is often domed and distorted and the single echo beam may pass through the base rather than the apex of the domed cusps. All methods have limitations in quantities of severity although it is accepted that an abnormal M-mode appearance does indicate an abnormal aortic valve. Cross-sectional echocardiography supplies additional spatial orientation and in children has been used to measure aortic cusp separation (4). In adults the orifice of the stenosed valve is often irregular in shape. This study attempted to measure directly aortic valve orifice area using cross-sectional echocardiography in a group of patients with aortic valve stenosis.