Aortic valve area in aortic stenosis
- William H Gaasch, MD
William H Gaasch, MD
- Section Editor — Valvular Disease
- Professor of Medicine
- University of Massachusetts Medical School
- Tufts University School of Medicine
- Senior Consultant in Cardiology
- Lahey Clinic
In individuals with normal aortic valves, the valve area is 3.0 to 4.0 cm2. As aortic stenosis develops, minimal valve gradient is present until the orifice area becomes less than half of normal. The pressure gradient across a stenotic valve is directly related to the valve orifice area and the transvalvular flow . As a result, in the presence of a depressed cardiac output, relatively low pressure gradients can be seen in some patients with severe aortic stenosis. (See "Low flow, low gradient severe aortic stenosis".) On the other hand, during exercise or other high flow states, systolic impulse-gradients can be measured in patients with minimally stenotic or even normal valves .
Complete assessment of the degree of aortic stenosis requires:
●Measurement of the transvalvular flow
●Determination of the transvalvular pressure gradient
●Calculation of the aortic valve area
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- Doppler echocardiography
- - Pressure gradient
- - Aortic valve area by continuity principle
- - Aortic valve resistance
- - Energy loss index
- - Rate of change in aortic valve area
- Planimetry of aortic valve area
- OTHER NONINVASIVE IMAGING
- Cardiovascular magnetic resonance
- Computed tomography
- CARDIAC CATHETERIZATION
- Gorlin equation for aortic valve area
- Aortic valve resistance
- Subvalvular gradients
- CRITICAL VALVE AREA AND SEVERITY
- Valve area and symptoms
- Indexing for body size
- LOW GRADIENT AORTIC STENOSIS