Echocardiographic Evaluation of Valvular Stenosis: The Gold Standard for the Next Millennium?

Abstract

Over the past decade, utilization of cardiac catheterization for preoperative hemodynamic assessment of patients with mitral and aortic stenosis has steadily decreased. The reason for this trend is the use of echocardiography, which is emerging as a gold standard for clinical characterization of valvular lesions. Since cardiac catheterization is an invasive procedure that is associated with a significant percentage of complications, echocardiographic evaluation of patients with valvular stenosis is safer and more cost-effective. In the next millennium, echocardiography will probably completely replace the use of catheterization for hemodynamic assessment of the severity of mitral and aortic stenosis.

Echocardiographic Evaluation of Aortic Valve Stenosis

“…Despite the above limitations and potential errors, the assessment of aortic stenosis severity by Doppler echocardiography remains the mainstay of noninvasive assessment in this disease entity [19,20]. Subsequent discussion will discuss standard techniques for Doppler echocardiography in aortic stenosis.…”

Diagnostic Accuracy of Handheld Echocardiography for Evaluation of Aortic Stenosis

“…3 Echocardiography has become the key diagnostic tool for the evaluation of patients with suspected AS, since the severity of AS, the degree of valve calcification, LV function, and the presence of other associated valve diseases can be accurately assessed. 4,5 Recently, new handheld ultrasound devices (HCU) with harmonic imaging and pulsedwave Doppler (pw-Doppler) and continuouswave Doppler (cw-Doppler) have been introduced into clinical practice. 6 The accuracy of these new devices for the assessment of suspected AS has not been demonstrated yet.…”

“…Since the presence of severe symptomatic AS is associated with increased mortality and morbidity, early identification of these patients is crucial 3 . Echocardiography has become the key diagnostic tool for the evaluation of patients with suspected AS, since the severity of AS, the degree of valve calcification, LV function, and the presence of other associated valve diseases can be accurately assessed 4,5 …”

Aortic Valve Sclerosis: Is It a Cardiovascular Risk Factor or a Cardiac Disease Marker?

“…Echocardiography is the gold standard diagnostic tool for the identification of aortic valve sclerosis. Echocardiography was initially utilized to study degenerative lesions of mitral valve, 3–5 and this uncovered the association of mitral valve lesions with aortic valve lesions 6,7 . In fact, roughly 50% of patients with aortic sclerosis are also affected by mitral valve sclerosis 8 .…”

“…Echocardiography was initially utilized to study degenerative lesions of mitral valve, [3][4][5] and this uncovered the association of mitral valve lesions with aortic valve lesions. 6,7 In fact, roughly 50% of patients with aortic sclerosis are also affected by mitral valve sclerosis. 8 For many years it has been thought that aortic valve sclerosis carries a good prognosis as compared to aortic stenosis.…”