The role of jet eccentricity in generating disproportionately elevated transaortic pressure gradients in patients with aortic stenosis.

Authors: Abbas, Amr E.; Franey, Laura M.; Lester, Steven; Raff, Gilbert; Gallagher, Michael J.; Hanzel, George; Safian, Robert D.; Pibarot, Philippe
Abstract: In patients with aortic stenosis (AS) and eccentric transaortic flow, greater pressure loss occurs as the jet collides with the aortic wall together with delayed and diminished pressure recovery. This leads to the elevated transaortic valve pressure gradients noted on both Doppler and cardiac catheterization. Such situations may present a diagnostic dilemma where traditional measures of stenosis severity indicate severe AS, while imaging modalities of the aortic valve geometric aortic valve area (GOA) suggest less than severe stenosis. In this study, we present a series of cases exemplifying this clinical dilemma and demonstrate how color M-mode, 2D and 3D transthoracic (TTE) and transesophageal (TEE) echocardiography, cardiac computed tomography angiography (CTA), and magnetic resonance imaging (MRI), may be used to resolve such discrepancies.
Document Type: Article de recherche
Issue Date: 1 February 2015
Open Access Date: Restricted access
Document version: VoR
This document was published in: Echocardiography, Vol. 32 (2), 372–382 (2015)
Alternative version: 10.1111/echo.12712
Collection:Articles publiés dans des revues avec comité de lecture

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