Aortic Stenosis

  Aortic Insufficiency
  AV Prosthesis
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  Mitral Regurgitation
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  Peak Aortic Flow Velocity
  Low Gradient AS
  Mean Doppler Gradient
  Estimated AVA cm2/m2

  ACC Recommendations
  ACC Recommendations 2

    Aortic Stenosis
    V1VTI (LVOT Velocity Time Integral) V2VTI (Aortic Velocity Time Integral) V1VTI/V2VTI    
    <0.2 Critical;  <0.25 Severe;  <0.25-0.30 Moderately Severe;  >0.30 Mild or Moderate (Shah 2004, Excellent ~AVA.)    
    Est. Mean Gradient from peak aortic flow velocity.           Peak Aortic Flow Velocity = Est. Mean Ao Gradient =    
    Est. Mean Gradient = ((4*(Peak Flow^2))*0.8) - 10      
    Patient Height in meters = Patient Weight in kilograms = Patient BSA in meters^2 =    
    LVOT Velocity = Estimated Minimum AVA = Est. Minimum AVA/m2 =    
    Aortic Velocity = Estimated Maximum AVA = Est. Maximum AVA/m2 =    
    To trigger calculations, press TAB.


Peak aortic flow velocity (PAFV): (4*V2^2-V1^2) or (4*V2^2). PAFV does not correlate with cath-measured 
gradient. PAFV may exceed 50 mmHg without severe aortic stenosis being present. PAFV is meaningful if it is greater than 80 mmHg. It is essential to include V1 if it exceeds 2.0 m/s. Pressure recovery in aortic stenosis without post-stenotic dilatation. (Pravin Shah, 2004)   Click the PAFV button (left hand column, above) for Prognostic Value of Peak Aortic Flow Velocity graph from Dr. Otto.

  Mean Doppler Gradient (MDG): Correlates well with cath measured mean gradient. If MDG is >40 mmHg, it is generally associated with severe aortic stenosis. If MDG is >50 mmHg, it is generally associated with critical aortic stenosis. (Pravin Shah, 2004)



Source: ACC/AHA Guidelines 2006.