Evaluation of elevated peak prosthetic aortic jet velocity

Algorithm for evaluation of elevated peak prosthetic aortic jet velocity incorporating DVI, jet contour, and AT.

AVR: aortic valve replacement; DVI: Doppler velocity index (Velocity_LVO/Velocity_PrAV) is the dimensionless ratio of the proximal velocity in the LVO tract to that of flow velocity through the prosthetic valve; AT: acceleration time; PrAV: prosthetic aortic valve; LVOT: left ventricular outflow tract; EOA: effective orifice area; PPM: patient-prosthetic mismatch; PW: pulsed wave; CW: continuous wave; TEE: transesophageal echocardiography.

* PW Doppler sample too close to the valve (particularly when jet velocity by CW Doppler is ≥4 m/s).

¶ Stenosis further substantiated by EOA derivation compared with reference values if valve type and size are known. Fluoroscopy and TEE are helpful for further assessment, particularly in bileaflet valves.

Δ PW Doppler sample too far (apical) from the valve (particularly when jet velocity is 3 to 3.9 m/s).

Reproduced from: Zoghbi WA, Chambers JB, Dumesnil JG, et al. Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr 2009; 22:975. Illustration used with the permission of Elsevier Inc. All rights reserved.

Graphic 98552 Version 3.0

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Evaluation of elevated peak prosthetic aortic jet velocity