DK2985_C000 1..28 - AlSharqia Echo Club

346 Transesophageal Echocardiography(A)(B)NCCLCCB(C)Area = 0.433 x L 2 RCCLAorticValveLLFigure 15.24 (A, B) Mid-esophageal short-axis view of an aortic valve in a 42-year-old man with Ehler–Danlos’ disease. (C) The areaof the equilateral triangle represents the average aortic valve area during systole (L, length; LCC, left coronary cusp; NCC, non-coronarycusp; RCC, right coronary cusp).(A)(B)LVLAAoLVOTDiameter (D):VTI:Max Velocity:1.85 cm18.8 cm90.9 cm/sRVAortic ValveVTI AoV:Max Velocity:45.7 cm231 cm/sThermodilution SV: 56 mlAORTIC VALVE VELOCITY (By CWD)(C)(D)LVOT VELOCITY (By PWD)LVOT flow= 0.785 D 2 x Velocity LVOT= 244.2 cm 3 /sAVA using Vmax= 244.2 cm 3 /s = 1.1 cm 2231 cm/sAVA using VTI= 0.785 D 2 x 18.8 cm = 1.1 cm 245.7 cmAVA using TD= 56 cm 3 = 1.2 cm 245.7 cmFlow velocity ratio= 90.9 cm/s = 39.4 %231 cm/sFigure 15.25 (A, B) Mid-esophageal long-axis view of the left ventricular outflow tract (LVOT) in a 71-year-old woman with aorticstenosis. (C, D) The aortic valve area (AVA) is calculated using the maximum (Max) velocity across the aortic valve and either the LVOTflow velocity or stroke volume derived from thermodilution (TD) (Ao, aorta; CWD, continuous-wave Doppler; D, diameter; LA, leftatrium; LV, left ventricle; PWD, pulsed-wave Doppler; RV, right ventricle; SV, stroke volume; VTI, velocity–time integral).