Comparison of Multiplane and Biplane Transesophageal Echocardiography in the Assessment of Aortic Stenosis
Section snippets
Methods
The study extended over a period of 18 months and included 145 patients. The study population included all patients with aortic stenosis who had transthoracic echocardiography, left and right heart catheterization, intraoperative TEE, and intraoperative evaluation of the aortic valve. However, 10 other patients with associated severe aortic regurgitation were excluded from the study because the aortic valve area cannot be reliably calculated at cardiac catheterization in the presence of severe
Results
During cardiac catheterization, pressure gradients across the aortic valve and aortic valve area by Gorlin equation were measured in 140 of 145 patients. They were not measured in 5 patients. There was no significant difference between aortic valve areas of bicuspid and tricuspid aortic stenosis.
With use of transthoracic echocardiography, the aortic valve area could be calculated in 138 of 145 patients studied. It was not available in 7 patients. Correlation between aortic valve area determined
Discussion
In the present study, multiplane TEE was found to be superior to biplane TEE in the assessment of aortic valve orifice when compared with cardiac catheterization (r = 0.89 for multiplane and 0.74 for biplane technique, p <0.01). Also, intra- and interobserver variability was very low. The multiplane transducer consistently allows for the aortic valve to be viewed in true short axis. This was most frequently found between plane angulations of 31° to 60°. As a result, the valve orifice could be
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Cited by (27)
Three-dimensional imaging of the left ventricular outflow tract: Impact on aortic valve area estimation by the continuity equation
2012, Journal of the American Society of EchocardiographyCitation Excerpt :The limitations of AVA calculations using cardiac catheterization and the Gorlin formula are well known.6,31,32 Measurement of AVA using transesophageal echocardiographic planimetry is semi-invasive and has limitations, especially with heavy calcifications.2,4 Measurements of AVA by TEE and by CCTA has been compared in only a small number of patients.13,22
Aortic Stenosis Quantitation
2010, Dynamic EchocardiographyComparison of Dual-Source Computed Tomography for the Quantification of the Aortic Valve Area in Patients With Aortic Stenosis Versus Transthoracic Echocardiography and Invasive Hemodynamic Assessment
2009, American Journal of CardiologyCitation Excerpt :However, previous studies, which compared the AVA assessed using multidetector CT to the planimetric results of transesophageal echocardiography reported inconsistent results with moderate correlation and relatively wide limits of agreements.6,7 Furthermore, the assessment of the aortic valve using transesophageal echocardiography has demonstrated poor reliability in patients with severely stenotic aortic valves, in part explained by the acoustic shadowing in the case of heavy valvular calcification and the difficulty and potential inability to identify the accurate imaging plane for planimetry.28–30 Therefore, we decided to compare our results to the clinically routinely used TTE and the hemodynamic assessment of aortic valve function.
Aortic Stenosis
2009, Valvular Heart Disease: A Companion to Braunwalds Heart Disease Expert Consult - Online and PrintEvaluation of Valvular Heart Disease by Echocardiography
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2008, Practice of Clinical Echocardiography, Thrid Edition