Aortic valve regurgitation

2021 ◽  
pp. 181-190
Author(s):  
Julien Magne ◽  
Patrizio Lancellotti
Keyword(s):  
Aortic Valve ◽  
Transoesophageal Echocardiography ◽  
Correct Identification ◽  
Short Axis ◽  
Short Axis View ◽  
Valve Regurgitation ◽  
Chamber View ◽  
Imaging Tool ◽  
Line Imaging ◽  
Axis View

Transthoracic echocardiography (TTE) is the first-line imaging tool to assess aortic valve (AV), aorta, and subsequent aortic regurgitation (AR). The parasternal long-axis view is classically used to measure the left outflow tract, the aortic annulus, and the aortic sinuses. Leaflet thickening and morphology can be visualized from this window as well as from the parasternal short-axis view and the apical five-chamber view. Nevertheless, 2D TTE may be limited and not enabling correct identification of the anatomy and causes of AR. In this situation, 3D echocardiography and cardiac magnetic resonance (CMR) could provide better delineation of the AV morphology. In some cases, transoesophageal echocardiography (TOE) could be required, more particularly for assessing the aortic root dimensions.

Transoesophageal examination

2020 ◽  
pp. 419-492
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Pulmonary Artery ◽  
Interatrial Septum ◽  
Atrial Septum ◽  
Short Axis ◽  
Chamber View ◽  
Sedation And Analgesia ◽  
Axis View

This chapter deals with transoesophageal examination. It covers indications; contraindications and complications; information for the patient; preparing for the study; preparing and cleaning the probe; probe movements; anaesthesia, sedation, and analgesia; sedation complications; intubation; image acquisition; 4-chamber view; 5-chamber view; short axis (aortic valve) view; short axis (right ventricle) view; long axis (aortic valve) view; long axis (mitral valve) view; atrial septum (bicaval) view; 2-chamber (atrial appendage) view; pulmonary vein views; coronary sinus view; transgastric short axis views; transgastric long axis view; transgastric long axis (aortic) view; transgastric right ventricular view; deep transgastric view; pulmonary artery view; aortic views; 3D oesophageal views; 3D mitral valve; 3D aortic valve; 3D tricuspid valve; 3D pulmonary valve; 3D left ventricle; 3D interatrial septum; and the X-plane.

scholarly journals 1044 Simple echocardiographic scoring in screening for aortic stenosis by emergency physicians in the emergency department

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Furukawa ◽  
Y Abe ◽  
T Miyaji ◽  
M Hatakenaka ◽  
M Naito ◽  
...  
Keyword(s):  
Emergency Department ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Predictive Value ◽  
Continuity Equation ◽  
Aortic Valve Area ◽  
Short Axis ◽  
Short Axis View ◽  
Emergency Physicians ◽  
Axis View

Abstract Background; Aortic stenosis (AS) is one of the important critical diseases and may influence hemodynamics in cardiovascular or non-cardiovascular emergency, however, there is no established methodology to diagnose AS in a focused cardiac ultrasound (FOCUS). We have previously reported that our developed visual AS score was a simple index for AS screening using rapid echocardiography and it could successfully diagnose clinically significant AS. The purpose of the present study was to evaluate the diagnostic accuracy of visual AS score assessed by emergency physicians in the emergency department. Methods; Visual AS score was calculated as the sum of the scores of each three aortic cusp’s opening in a short-axis view scored as follows: 0 = not restricted, 1 = restricted, or 2 = severely restricted; and classified in 0 – 6 as we previously reported. Emergency physicians who did not specialize in cardiology or ultrasonography underwent basic 30 minutes training to visualize aortic valve in a short-axis view and to assess visual AS score beforehand. They performed echocardiography and evaluated visual AS score in emergency outpatients with suspected cardiovascular diseases such as chest symptom, consciousness disorder, abnormal vital signs, heart murmur or abnormal electrocardiogram in the emergency department. Then, another assessment of visual AS score and complete echocardiography including quantitative assessment of AS was performed by expert sonographers. Aortic valve area index (AVAI) was calculated using continuity equation and body surface area, and an AVAI > 0.85 cm/m2, 0.6 - 0.85 cm/m2, and < 0.6 cm/m2 were defined as none or mild, moderate and severe AS, respectively. Results: Sixty patients underwent evaluations of visual AS score by emergency physicians. Visual AS score could not be assessed in 5 patients and continuity equation could not be evaluated in 2 patients, both due to poor echocardiographic imaging quality. Visual AS scores assessed by emergency physicians and expert sonographers showed strong positive correlation (R = 0.94, P < 0.0001). Fourteen patients (26 %) including 6 with shock or hypotension, 3 with congestive heart failure, 2 with syncope, 1 with acute myocardial infarction, 1 with suspected cardiac tamponade and 1 with abnormal electrocardiogram had moderate or more degree of AS in complete echocardiography performed by expert sonographers. Visual AS score 3 or more assessed by emergency physicians had 86 %, 100 %, 100 % and 95 % of a diagnostic sensitivity, specificity, positive predictive value and negative predictive value, respectively. Conclusion: Visual AS score in FOCUS is useful to screen for AS for emergency physicians who do not specialize in cardiology.

scholarly journals The Application of Transesophageal Echocardiography in Mitral Valve Repair With Tendon Reconstruction

2020 ◽  
Vol 7 ◽  
Author(s):  
Li Zhou ◽  
Ji-wei Gu ◽  
Yun Wang ◽  
Jing-jing Ye ◽  
Fang Wang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Transesophageal Echocardiography ◽  
Mitral Valve Repair ◽  
Tendon Rupture ◽  
Short Axis ◽  
Short Axis View ◽  
Valve Repair ◽  
Tendon Reconstruction ◽  
Axis View

Objective: To investigate whether tendon reconstruction during mitral valve repair can be effectively guided by transesophageal echocardiography (TEE), using the mid-esophageal bi-commissure view, bicaval view and the aortic valve–mitral valve transition short-axis view.Methods: A total of 40 patients that underwent mitral valve repair with artificial tendineae were recruited. Before the operation, conventional transthoracic echocardiography was used to determine whether mitral valve repair would be possible. Following intraoperative anesthesia, two-dimensional and three-dimensional TEE reconstructions were used to assess the state of the valve and tendon and to make a repair plan.Results: TEE accurately diagnosed single functional tendon rupture and predicted single artificial tendon implantation in 88% of cases (23/26). TEE accurately diagnosed single functional tendon rupture and predicted the implantation of two artificial tendons in 100% of cases (4/4). TEE accurately diagnosed two or more functional tendon ruptures and predicted the implantation of two artificial tendons in 100% of cases (5/5). The length of the tendon cord predicted by TEE (2.45 ± 0.15 mm) was not significantly different (P > 0.05) from the length of the cord that was actually implanted (2.31 ± 0.11 mm). TEE also accurately predicted the size of the annuloplasty ring in 86% of cases (33/38), with differences of 2 mm or less compared to the size of the ring that was actually implanted.Conclusion: Both the mid-esophageal bi-commissure view, bicaval view and the short-axis view of the aortic valve–mitral valve transition can reduce the difficulty of tendon reconstruction by helping to determine what length of tendon and what size of artificial annulus are required.

Transthoracic examination

2020 ◽  
pp. 71-126
Keyword(s):  
Image Quality ◽  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Abdominal Aorta ◽  
Image Acquisition ◽  
Vena Cava ◽  
Short Axis ◽  
3D Image ◽  
Chamber View ◽  
Axis View

This chapter covers all aspects of transthoracic examination, including patient information, preparing machine and probe, probe handling and image quality, 2D image acquisition, 3D image acquisition, multiplane image acquisition, data acquisition, parasternal long axis view, parasternal right ventricle inflow view, parasternal right ventricle outflow view, parasternal short axis (aortic) view, parasternal short axis (mitral) view, parasternal short axis (ventricle) views, parasternal 3D views, apical 4-chamber view, apical 5-chamber view, apical 2-chamber view, apical 3-chamber view, apical 3D views, subcostal views, inferior vena cava view, abdominal aorta view, suprasternal view, right parasternal view, and standard examination.

Echocardiographic two-dimensional view of the pulmonary valve in infants: the high transsternal view

2015 ◽  
Vol 26 (4) ◽  
pp. 790-792
Author(s):  
Miguel A. Granados ◽  
Leticia Albert ◽  
Belén Toral
Keyword(s):  
Older Patients ◽  
Pulmonary Valve ◽  
Thymus Gland ◽  
Age Group ◽  
Short Axis ◽  
Two Dimensional ◽  
Short Axis View ◽  
Axis View

AbstractNeonates and small infants have unique characteristics that make it possible to obtain echocardiographic views that are inaccessible in older patients. A high transsternal approach through the cartilaginous sternum and the thymus gland allows visualisation of a short-axis view of the pulmonary valve. This view should be included as part of routine protocols for echocardiographic examinations performed in this age group.

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