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What Is The Significance Of The AJV Versus Aortic Valve Area?
Question: I am a 69 yo male who has had aortic stenosis for a few years. My Aortic jet velocity went from 3.9 in Nov. to 4.1 just recently. This was the only data point shared by the echo and indicates severe state. What is the significance of the AJV versus lets say my aortic valve area which I do not know?
Brief Answer:
Further data is required
Detailed Answer:
Hello and welcome to HCM. I understand your concern. Thank you for your question.
Well, a cardiologists, we do not rely a lot on the aortic jet velocity. It is more that we rely really on the pressure difference between the left ventricle and the aorta, which makes us further proceed with evaluating the gravity of the aortic stenosis. My opinion is that whatever the test results, the echo should show the gradient pressure between the two chambers I stated above. This gradient is used today to mark the gravity of the aortic stenosis, and decide whether it is to be surgically replaced or not. Also, an important fact is also depicted by echocardiogram, is this a bicuspid aorta (because normally aorta has three cuspises, and up to 10% of people it is found with two cuspises), or not. Also, the valvular area is the third most important part that should be investigated, after it has been confirmed or excluded whether it is with two or three cuspises, and what is the gradient. In the mean time, a mean gradient of above 40 mmHg requires aortic valve replacement. If this is the case, a coronary angiogram is required first, to depict whether there are or are not coronary plaques present. If this is the case, during the aortic replacement, if there are coronary artery plaques present, also coronary bypass is carried out.
I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.
Best regards,
Dr. Meriton
Further data is required
Detailed Answer:
Hello and welcome to HCM. I understand your concern. Thank you for your question.
Well, a cardiologists, we do not rely a lot on the aortic jet velocity. It is more that we rely really on the pressure difference between the left ventricle and the aorta, which makes us further proceed with evaluating the gravity of the aortic stenosis. My opinion is that whatever the test results, the echo should show the gradient pressure between the two chambers I stated above. This gradient is used today to mark the gravity of the aortic stenosis, and decide whether it is to be surgically replaced or not. Also, an important fact is also depicted by echocardiogram, is this a bicuspid aorta (because normally aorta has three cuspises, and up to 10% of people it is found with two cuspises), or not. Also, the valvular area is the third most important part that should be investigated, after it has been confirmed or excluded whether it is with two or three cuspises, and what is the gradient. In the mean time, a mean gradient of above 40 mmHg requires aortic valve replacement. If this is the case, a coronary angiogram is required first, to depict whether there are or are not coronary plaques present. If this is the case, during the aortic replacement, if there are coronary artery plaques present, also coronary bypass is carried out.
I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much for your response! I have an appointment with a surgeon this Thursday. Are there any additional questions I can ask besides your data points? I am not aware if this is a bicuspid aorta. I will ask that. Anything else to ask will help. I trust the surgeon will objectively evaluate a candidate for replacement properly. If not, any other questions that I can ask him will be greatly appreciated.
Brief Answer:
No further questions
Detailed Answer:
Hi again.
Well, in these cases, I think that an echo cardiogram report should suffice, for the surgeon to make a decision within two alternatives: whether to proceed with the surgery and the strategy I provided in the original answer, or to continue to "keep an eye" on the stenosis with echo, until it becomes operable. I am glad I helped.
Kindly, close the discussion and rate the answer, if you do not have further questions.
Good luck and wish you the best,
Dr. Meriton
No further questions
Detailed Answer:
Hi again.
Well, in these cases, I think that an echo cardiogram report should suffice, for the surgeon to make a decision within two alternatives: whether to proceed with the surgery and the strategy I provided in the original answer, or to continue to "keep an eye" on the stenosis with echo, until it becomes operable. I am glad I helped.
Kindly, close the discussion and rate the answer, if you do not have further questions.
Good luck and wish you the best,
Dr. Meriton
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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