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Transoesophageal Echocardiography - part 8

Các tính năng Tờ rơi dày, bất động, vôi hóa AV Commissural phản ứng tổng hợp (thấp khớp) Doming "của tờ rơi AV Giảm AV mở Associated LVH + / - giãn động mạch chủ gốc Đánh giá của AS mức độ nghiêm trọng (1) Planimetry: nặng AS đề nghị nếu AV khu vực | 102 Transoesophageal Echocardiography 2 Acquired Rheumatic Degenerative calcification Amyloid Features Thick immobile calcified AV leaflets Commissural fusion rheumatic Doming of AV leaflets Reduced AV opening Associated LVH - dilated aortic root Assessment of AS severity 1 Planimetry severe AS suggested if AV area 0.7 cm2 2 Continuity equation AVA Alvot X VTIlvot VTIav AVA Alvotx Vlvot Vav 3 Gorlin formula AVA CO HR X ET X 44ỰMG Co Cardiac output HR Heart rate ET Ejection time MG Mean gradient 4 Doppler pressure gradients normal vmax 1.5 m s Table 6.2 Peak PG vs. Peak-to-peak PG Fig. 6.7 P1 peak PG by Doppler Instantaneous Maximum difference between aorta and LV pressures during systole at one instant in time P2 peak-to-peak pressure in cardiac catheter lab 104 Transoesophageal Echocardiography Infective endocarditis Trauma b Annulus pathology Infection syphilis Thoracic aortic aneurysm Ascending aortic dissection Features Premature closure of MV Poor coaptation of AV leaflets Dilated aortic root Assessment of AI severity 1 Jet length inaccurate Mild 2 cm Moderate 2 cm papillary muscles Severe beyond papillary muscles 2 Perry index jetheight LVOT diameter Mild 25 Moderate 25-60 Severe 60 3 Regurgitant fraction volume RF VoIai VoIlvot X 100 Mild 30 Moderate 30-50 Severe 50 Regurgitant volume 60 ml severe AI 4 Pressure half-time PHT Mild 550 ms Moderate 300-550 ms Severe 300 ms 5 Flow reversal Mild ascending aorta Moderate descending thoracic aorta Severe abdominal aorta Valvular heart disease 105 Table 6.3 Assessment of aortic incompetence using Perry index pressure half-time PHT regurgitant fraction RF and aortic flow reversal AoFR Perry index PHT ms RF AoFR Mild 25 550 30 Ascending aorta Moderate 25-60 300-550 30-50 Desc. thor. aorta Severe 60 300 50 Abdominal aorta Summary of AI assessment Table 6.3 Tricuspid valve Tricuspid stenosis Aetiology 1 Congenital TV atresia associated with RV hypoplasia 2 Acquired Rheumatic Carcinoid Endocardial fibroelastosis .