Comparison of preoperative and intraoperative assessment of aortic stenosis severity by echocardiography

British Journal of Anaesthesia
Y UdaR Kluger

Abstract

General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE). Additionally, agreement of preoperative and intraoperative grading of AS based on these measurements was assessed. Data from 319 patients were analysed. On average, intraoperative TOE peak velocity and mean gradient were lower by 0.59 m s -1 and 12.5 mm Hg, respectively ( P <0.0001), compared with preoperative TTE measurements, whereas the difference in mean DI was minimal at 0.008. Preoperative and intraoperative grades of AS severity (mild, moderate, and severe) by peak velocity, mean gradient, and DI agreed in 53.3, 53.7, and 83.3% of patients, respectively. The TOE grade of AS severity by peak velocity and mean gradient was at least one lower than the TT...Continue Reading

References

Dec 10, 2008·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Helmut BaumgartnerUNKNOWN EAE/ASE
Jun 5, 2012·Journal of the American College of Cardiology·Helmut Baumgartner
Jun 15, 2012·Anesthesia and Analgesia·Peter von Homeyer, Donald C Oxorn
Aug 28, 2012·European Heart Journal·UNKNOWN Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC)Marian Zembala
Jun 22, 2015·JACC. Cardiovascular Imaging·Dan RusinaruChristophe Tribouilloy
Jul 18, 2015·JACC. Cardiovascular Imaging·William A Zoghbi

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