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Version 2018.011.20063 Size 141.69 MB 2018.011.20063 xforce keygen 64-bit.Assessment of aortic valve area from transesophageal Doppler measurements of proximal pressure gradient in the beating heart.
Patient evaluation for aortic valve replacement frequently includes calculation of the aortic valve area (AVA) from Doppler data acquired from the proximal ascending aorta. To date, measurements have been performed during cardiac catheterization under anesthesia, which is not ideal for patients who may not tolerate prolonged catheterization and for patients who may require repeat evaluations. In an attempt to overcome these limitations, we evaluated a Doppler-derived calculation of AVA in patients with aortic stenosis during the beating heart under transesophageal echocardiographic guidance. A total of 15 patients with aortic stenosis were studied. AVA was measured by direct planimetry and by two echocardiographic methods, the continuity equation (CE) and the pressure half-time (PHT) method. The proximal pressure gradient across the aortic valve was also measured. There were no significant differences in the calculated AVA between planimetry and CE or PHT. Calculated AVA by planimetry correlated closely with direct planimetry (r = 0.97), the CE (r = 0.96), and the PHT method (r = 0.91). The mean proximal pressure gradient was 9 +/- 5 mm Hg, and there was no significant difference in mean proximal pressure gradient or AVA between patients undergoing aortic valve replacement and those who were not. This technique can be used to measure AVA in patients with aortic stenosis and is better tolerated than cardiac catheterization.Arts & Culture
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