Estimation of aortic valve effective orifice area by Doppler echocardiography: effects of valve inflow shape and flow rate

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Damien GarciaLouis-Gilles Durand

Abstract

The effective orifice area (EOA) is the standard parameter for the clinical assessment of aortic stenosis severity. It has been reported that EOA measured by Doppler echocardiography does not necessarily provide an accurate estimate of the cross-sectional area of the flow jet at the vena contracta, especially at low flow rates. The objective of this study was to test the validity of the Doppler-derived EOA. Triangular and circular orifice plates, funnels, and bioprosthetic valves were inserted into an in vitro aortic flow model and were studied under different physiologic flow rates corresponding to cardiac outputs varying from 1.5 to 7 L/min. For each experiment, the EOA was measured by Doppler and compared with the catheter-derived EOA and with the EOA derived from a theoretic formula. In bioprostheses, the geometric orifice area (GOA) was estimated from images acquired by high-speed video recording. There was no significant difference between the EOA derived from the 3 methods with the rigid orifices (Doppler vs catheter: y = 0.97x +0.18 mm(2), r(2) = 0.98; Doppler vs theory: y = 1.00x -3.60 mm(2), r(2) = 0.99). Doppler EOA was not significantly influenced by the flow rate in rigid orifices. As predicted by theory, the avera...Continue Reading

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Citations

Apr 15, 2010·Journal of Biomechanical Engineering·E GaillardL-G Durand
Sep 21, 2006·Journal of Cardiothoracic Surgery·Giovanni MinardiFrancesco Musumeci
Mar 17, 2010·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Biljana Prcović
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Nov 26, 2005·Journal of Biomechanics·Damien GarciaLouis-Gilles Durand
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Jan 3, 2006·Journal of the American College of Cardiology·Lyes KademPhilippe Pibarot
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