title: [Planar determination of the aortic valve area with transesophageal echocardiography with multiplanar probe in patients with aortic stenosis and insufficiency. Comparison with transthoracic Doppler echocardiography].
abstract: BACKGROUND
  The simple determination of transaortic pressure gradient does not accurately assess the severity of an aortic valve stenosis. Thus, estimating the aortic valve area (AVA) is vital for clinical decision-making. Cardiac catheterization has been considered the "gold-standard" for the quantification of the stenotic valve area, but this technique may underestimate the actual valve area when aortic regurgitation is associated. Doppler transthoracic echocardiography (TTE) with the continuity equation method is usually employed for AVA estimation. Recently, in pure aortic stenosis, transesophageal echocardiography (TEE) has provided AVA values well-correlated to hemodynamic invasive results.
  
  
  METHODS
  In this study, we correlated AVA values by TTE and multiplane TEE in 18 patients with combined aortic valve stenosis and regurgitation.
  
  
  RESULTS
  The mean values of AVA by TEE and TTE were 0.74 +/- 0.12 and 0.68 +/- 0.55 cm2, respectively (p = NS). TEE-derived AVA correlated well to TTE-derived AVA (r = 0.816; p < 0.0001). Critical aortic stenosis was predicted by TEE with 100% sensitivity and specificity. Total time of examination was significantly longer for TTE (p < 0.00001).
  
  
  CONCLUSIONS
  In conclusion, direct planimetry by multiplane TEE is a reliable method for AVA determination in aortic stenoinsufficiency. For this purpose, when the technical quality of TTE study is poor or when the patient is critically ill and does not tolerate a longer lasting TTE, multiplane TEE should be considered.
authors.affiliation: Istituto Di I Clinica Medica, Università La Sapienza, Roma.
authors.forename: S
authors.initials: S
authors.lastname: Morelli
authors.forename: S
authors.initials: S
authors.lastname: De Castro
authors.forename: D
authors.initials: D
authors.lastname: Cartoni
authors.forename: C
authors.initials: C
authors.lastname: Perrone
authors.forename: S
authors.initials: S
authors.lastname: Beni
authors.forename: M L
authors.initials: ML
authors.lastname: Bernardo
authors.forename: L
authors.initials: L
authors.lastname: Ferrante
authors.forename: M
authors.initials: M
authors.lastname: Giordano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D015150:Echocardiography, Doppler / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged