Aortic valve

Abstract

Echocardiographic evaluation of the aortic valve is not limited to just the valve leaflets itself but also should include the left ventricular outflow tract, sinuses of Valsalva, and the sinotubular junction. Echocardiographic evaluation of any valve pathology should include a thorough two-dimensional examination of the valve and associated anatomic findings, color flow Doppler interrogation, and spectral Doppler analysis. Aortic stenosis is one of the most common cardiac pathologies and can be caused by atherosclerotic thickening over time, congenital bicuspid disease, or rheumatic heart disease. The severity of the stenosis can be assessed by planimetry, spectral Doppler analysis using the continuity equation, mean gradient measurement, and by evaluation of color flow through the valve leaflets. Aortic regurgitation may be caused by root dilatation from vascular or connective tissue disease processes as well as leaflet pathology. Color flow Doppler analysis is a key to determining disease severity through measurement of the vena contracta and jet width to left ventricular outflow diameter. Measurement of the aortic regurgitation pressure half time and determining if there is any reversal of blood flow within the descending aorta will also help to assess disease severity.