Echo assessment of Aorta

and Aortic valve

Ascending Aorta

Sino tubular junction

Sinuses of Valsalva
Aortic annulus

Aortic valve
Appearance

Cusps
Closure line
Vegetations
Annulus

Movement
Chambers
Doppler

Aorta and Root

Appearance
Dimensions
Flow
Flaps
Thrombus or Atheroma

Colour
Pulsed
Continuous

Aortic Stenosis

Estimated pressure drop

Simplified Bernoulli equation
Peak Pressure drop = 4 x square of the peak
velocity
Mean Pressure drop = 4 x square of the VTI
of systolic AV flow

Modified Bernoulli equation

Pressure drop = 4 x (AVV- LVOTV)

Continuity Equation
Large CSA
Slow velocity

Small CSA
Fast velocity

But the same flow rate in volume per second

Aortic valve area

Continuity equation
Aortic valve and left ventricular outflow
tract
Cross sectional area x velocity time
integral = flow
Flow is the same in both areas
AV CSA x AV VTI= LVOT CSA x LVOT VTI
AV CSA = LVOT CSA x LVOT VTI divided by AV
VTI

Aortic valve area 2

Measure VTI in LVOT and across AV
Measure LVOT diameter just below valve

Aortic Regurgitation

Regurgitant jets
Proximal Isovelocity Surface Area

Vena Contracta

Long term FU
Yes look at valve features
But symptoms are very important
And careful monitoring LV dimensions
End Systolic diameter 5.5 or more

10

Aortic Pathology
Increased size
Diffuse
Focal

Atheroma
Haemorrhage
Dissection
Thrombosis

Aortic enlargement
Chest pain

11

Family Screening

12

Atypical Chest Pain

13

14

Top: Biplane TEE in the

Aortic Pathology by CT

Willens, H. J. et al. Chest 1999;116:1772-1779

Ruptured Penetrating Ulcer

Acute on Chronic Dissection

15

Acute on Chronic Dissection

Localised Enlargement
Sinus of Valsalva aneurysm

Sinus of Valsalva Aneurysm

Sinus of Valsalva Aneurysm with

fistula

SINHA, M. et al. Heart 2001;85:483

Copyright 2001 BMJ Publishing Group Ltd.

16

Summary

AS
AR
Aortic dilatation
Clear imaging often with multiple
modalities

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