ECHOCARDIOGRAPHIC ASSESSMENT OF （超声心动图评估）.pptx

ECHOCARDIOGRAPHIC ASSESSMENT OF AORTIC VALVE STENOSIS;Normal Aortic valve;2D Echo-Long axis view;2D Echo-Short axis view;2D - Apical five chamber view;2D – Suprasternal view;M Mode- Normal aortic valve;CAUSES AND ANATOMIC PRESENTATION;Aortic stenosis- Causes; Combination of short and long axis images to identify Number of leaflets Describe leaf mobility, thickness, calcification Combination of imaging and doppler allows the determination of the level of obstruction; subvalvular, valvular, or supravalvular. Transesophageal echocardiography may be helpful when image quality is suboptimal.;Calcific Aortic Stenosis;Calcific Aortic Stenosis;Calcific Aortic Stenosis;Bicuspid Aortic valve;Two cusps are seen in systole with only two commissures framing an elliptical systolic orifice(the fish mouth appearance). Diastolic images may mimic a tricuspid valve when a raphe is present. ;Bicuspid Aortic valve;Calcific Aortic Stenosis;Aortic sclerosis;Rheumatic aortic stenosis;Parasternal short axis view showing commissural fusion, leaflet thickening and calcification, small triangular systolic orifice ;Subvalvular aortic stenosis;Supravalvular Aortic stenosis;Type II - Thin, discrete fibrous membranelocated above the aortic valve The membrane usually mobile and may demonstrate doming during systole Type III- Diffuse narrowing;HOW TO ASSESS AORTIC STENOSIS;Doppler assessment of AS;Peak transvalvular velocity;AS jet velocity is defined as the highest velocity signal obtained from any window after a careful examination Any deviation from a parallel intercept angle results in velocity underestimation The degree of underestimation is 5% or less if the intercept angle is within 15? of parallel. ‘Angle correction’ should not be used because it is likely to introduce more error given the unpredictable jet direction.;The velocity scale adjusted so the spectral doppler signal fills on the vertical axis, and with a time scale on the x-axis of 100 mm/s Wall filters are set at a high level