EchocardiographyExercise StressMiscEchocardiography
Aortic Valve Velocity RatioLV EF (Modified Quinones Equation)Myocardial Performance Index (RV)
AVA (Continuity Equation VTI)LV EF (Simplified Quinones Equation)PCWP by E/Ea (Nagueh Formula)
AVA (Continuity Equation VMax)LV Fractional ShorteningPISA (Mitral regurgitation)
dP/dt (LV contractility)LV Mass and LV Mass IndexPISA (Mitral stenosis)
dP/dt (RV contractility)Mitral valve area (PHT)Qp/Qs
Left atrial pressure (MR)Mitral Valvuloplasty Score (MGH)RVSP (TR)
LA Volume (Biplane Method)Modified Bernoulli EquationStroke Volume, Cardiac Output
LV EF (Dumesnil Method)Myocardial Performance Index (LV)
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Aortic Valve Area (Continuity Equation using VTI)

Calculation


VTI1 cm Height
VTI2 cm Weight
LVOT mm


AVA cm2
AVA Index cm2/m2
Calculate

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Information

Definition of Aortic Stenosis Severity

AVA (cm2) AVAI (cm2/m2)
Normal 3.0-4.0
Mild >1.5 >0.85
Moderate 1.0-1.5 0.60-0.85
Severe <1.0 <0.6

Aortic Valve Area (VTI)

Aortic valve area can be calculated by using the principle of conservation of mass — "What comes in must go out".

Aortic valve area indexed to body surface area should be considered for the large and small extremes of body surface area.

For patients with prosthetic aortic valves, patient-prosthesis mismatch is suspected when effective orifice area (EOA) indexed to body surface area <0.85 to 0.9 cm2/m2. Patient-prosthesis mismatch is considered severe when EOA index <0.65.

EOA Index (cm2/m2)
Moderate <0.85
Severe <0.65

AVA =
π*(LVOT/2)2*VTI1
VTI2

Variable Definition
VTI1 Subvalvular velocity time integral (cm)
VTI2 Maximum velocity time integral across the valve (cm)
LVOT Left ventricular outflow tract diameter (cm)
Weight Weight (kg or lb)
Height Height (cm or in)
AVA Aortic Valve Area (cm2)
AVA Index Aortic Valve Area indexed to BSA (cm2/m2)

References

Baumgartner H, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr. 2009 Jan;22(1):8,10.
Zoghbi WA, et al. Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 1986; 73:452-459.
Grayburn PA, et al. Pivotal role of aortic valve area calculation by the continuity equation for Doppler assessment of aortic stenosis in patients with combined aortic stenosis and regurgitation. Am J. Cardiol 1988; 61:376-381.
Carabello BA, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. Circulation 2006; 114(5):e84-231.
Pibarot P, Dumesnil JG. Hemodynamic and clinical impact of prosthesis-patient mismatch in the aortic valve position and its prevention. J Am Coll Cardiol 2000;36:1131-41.
Jamieson E. et al. Surgical Management of Valvular Heart Disease 2004. Canadian Cadiovascular Society Consensus Conference. Can J Cardio Vol 2004; 20 Suppl E:18E-19E.
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