Author + information
- Received October 20, 2009
- Accepted November 8, 2009
- Published online March 1, 2010.
- David S. Bach, MD⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. David S. Bach, CVC Room 2147, SPC 5853, 1500 E. Medical Center Drive, University of Michigan, Ann Arbor, Michigan 48109-5853
Echocardiography/Doppler is the standard clinical tool for the assessment of hemodynamics after aortic valve replacement. Analysis can include mean and peak transvalvular gradients, dimensionless valve index, effective orifice area from the continuity equation, geometric orifice area from planimetry, and energy loss coefficient. High gradients after aortic valve replacement can be, but are not necessarily, caused by left ventricular outflow obstruction; and not all left ventricular outflow obstruction after aortic valve replacement is due to prosthesis dysfunction. Understanding the methods by which echocardiography and Doppler are used to noninvasively assess aortic valve hemodynamics, and the caveats associated with those methods, can help the clinician distinguish obstructive from nonobstructive causes of high gradients, and prosthesis dysfunction from other causes of obstruction.
Dr. Bach receives or has recently received research support from Edwards Lifesciences and Medtronic CardioVascular, and serves as a consultant to Edwards Lifesciences, Medtronic CardioVascular, St. Jude Medical, and CVRx.
- Received October 20, 2009.
- Accepted November 8, 2009.
- American College of Cardiology Foundation