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- Title
Measurement of Effective Aortic Valve Area Using Three-Dimensional Echocardiography in Children Undergoing Aortic Balloon Valvuloplasty for Aortic Stenosis.
- Authors
Bharucha, Tara; Fernandes, Fernanda; Slorach, Cameron; Mertens, Luc; Friedberg, Mark Kevin
- Abstract
Aims: Pressure gradient is used for timing of balloon aortic valvuloplasty for aortic stenosis (AS) in children, but does not correlate well with outcome and is limited if ventricular function is poor. In adults, effective orifice area (EOA) is used to assess AS severity, but EOA by continuity equation or 2D echo is unreliable in children. Three-dimensional echocardiography (3DE) may reliably assess EOA but has not been studied in children. We assessed measurement of aortic valve EOA by 3DE in children with AS before and after balloon aortic valvuloplasty and compared results with change in aortic valve gradient. Methods: 3DE was performed at time of catheterization before and after balloon aortic valvuloplasty. Using 3DE multiplanar review mode, valve annulus diameter, area, and EOA were measured and compared with change in aortic gradient and degree of aortic insufficiency. Results: Twenty-four 3DE studies in 12 children (mean age 4.4 ± 5.0 years) were analyzed. EOA was measurable in all. Catheter peak gradient decreased from 45 ± 10 to 26 ± 17 mmHg (P = 0.0018). 3DE EOA increased after balloon aortic valvuloplasty (0.59 ± 0.52 cm2 vs 0.80 ± 0.70 cm2; P = 0.03), without change in valve diameter. EOA change correlated with change in peak (r = 0.77; P = 0.005) and mean (r = 0.60; P = 0.03) aortic valve gradient post balloon aortic valvuloplasty. Conclusion: 3DE facilitates EOA measurement in pediatric AS and correlates with change in aortic valve gradient after balloon valvuloplasty. (Echocardiography 2012;29:484-491)
- Subjects
AORTIC stenosis; CATHETERIZATION; STATISTICAL correlation; DOPPLER echocardiography; ECHOCARDIOGRAPHY; RESEARCH evaluation; STATISTICAL hypothesis testing; T-test (Statistics); SECONDARY analysis; PRE-tests &; post-tests; INTER-observer reliability; SEVERITY of illness index; DATA analysis software; DESCRIPTIVE statistics; CHILDREN
- Publication
Echocardiography, 2012, Vol 29, Issue 4, p484
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2011.01595.x