ASE American Society of

Echocardiography
Heart & Circulation Ultrasound Specialists

Left ventricular outflow tract Left ventricular outflow tract Continuous wave Doppler of
diameter measured within velocity as measured from severe aortic stenosis jet.
0.5 to 1.0 cm of the valve the apical approach.
orifice. Data recording and measurement
for AS quantltatlon
Data
Recording Measurement
element
.
20 parastemal long axis view. . Inner edge to inner
. ..
LVOT
diameter• Zoom mode. edge.
Adjust gain to optimize the Mid-systole .
blood tissue interface. Parallel and
adjacent to the aortic
valve or at the site of
velocity measurement
. {see text).
Diameter is used to
calculate a circular

..
CSA.

LVOT Pulsed wave Doppler.

Apical long axis or 5-chamber
. Maximum velocity
from peak of dense
velocity
. view.
Sample volume positioned . velocity curve.
VTI traced from

.
just on LV side of valve and modal velocity.
moved careful!� Into the LVOT
if required to o tain laminar
. flow curve.
Velocity baseline and scale

.
ad,usted to maximize size of
ve ocity curve.
Time axis {sweep speed)
.. 100 mm/s.
Low wall filter setting .
Smooth velocity curve with a
well defined peak and a
narrow velocity range at peak
velocity.

. CW Doppler (dedicated . Maximum velocity

.
AS jet
velocity transducer). at peak of dense
Multiple acoustic windows
{e.�. apical, suprastemal, . velocity curve .
Avoid noise and
. rig t parastemal, etc).
Decrease gains, increase
wall filter, adjust baseline
. fine linear signals.
VTI traced from
outer edge of dense

.
and scale to optimize
signal.
Gray scale spectral display
. signal curve.
Mean gradient
calculated from
. with expanded time scale.
Velocity range and baseline
adjusted so velocity signal .
traced velocity
curve .
Report window
fits but fills the vertical where maximum

Valve
. scale.
Parastemal long and short
axis views.
. velocity obtained.
Identify number of
leaflets in systole,
anatomy. Zoom mode.
. raphe if present.
Assess leaflet
mobility and
. commissural fusion.
Assess valve
calcification.
CSA: cross HCtlonlil area, VTI: velocity-time lnt9gral.

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