Two-Dimensional Doppler Echocardiographic Derived Aortic Valve Area in Aortic Stenosis

Two-dimensional Doppler echocardiography provides qualitative and quantitative information in patients with aortic stenosis. An illustrative case is presented that describes the use of combining these techniques: two-dimensional echo for valve morphology, left ventricular outflow tract area and left ventricular systolic function, pulsed Doppler for estimating cardiac output, and continuous wave Doppler to derive peak and mean systolic gradients. In this patient, continuous-wave Doppler underestimated the severity of stenosis, based on the systolic peak and mean gradient due to reduction in the cardiac output. Patients who have aortic stenosis and ventricular dysfunction should also have the severity of the stenosis determined by estimating the valve orifice area with the continuity equation.