. 2021 Mar 11;8(1):G19–G59. doi: 10.1530/ERP-20-0035
This work is licensed under a Table 5.
TOE imaging in aortic stenosis.
| View (modality) | Measurement | Explanatory notes | Image |
|---|---|---|---|
| 5-chamber view; mid-oesophageal window; 0°; zoom 2D | Observe calcification and mobility of the cusps |  |
|
| 5-chamber view; mid-oesophageal window; 0°; zoom 2D + colour Doppler | Colour Doppler imaging to assess for turbulence and valve regurgitation |  |
|
| Short-axis view; mid-oesophageal window; 40–60°; the level of the aortic cusps 2D | Assess for valve morphology, cusp mobility and calcification |  |
|
| Short-axis view; mid-oesophageal window; 40–60°; at the level of the aortic cusps 2D zoom + colour Doppler | Assess for AR Colour Doppler may help identify morphology (shown is tricuspid valve; see ‘Anatomy’ section) |  |
|
| 3D dataset | Consider planimetry | Overview and optimized images for planimetry |  |
| Long-axis view; mid-oesophageal window; 120–140°; 2D imaging | Measurement of LV size and wall thickness Indexed LV mass calculation | Observe calcification and mobility of the cusps LV size and function Indexed LV mass is a prognostic sign |  |
| Long-axis view; mid-oesophageal window; 120–140°; 2D imaging zoom | LVOT dimension (not shown) Measurement of aorta | Inner-edge to inner edge method; end-diastole Red = Sinus of Valsalva Green = ST junction Blue = Ascending |  |
| Short-axis view; trans-gastric window; 0°; at the level of the aortic cusps 2D + colour Doppler | Manipulation of probe to ‘open’ aortic valve (marked with ‘AV’) Assessment of turbulence and the presence of AR |  |
|
| Long-axis view; trans-gastric window; 120–140°; 2D imaging + colour Doppler | Assess for AR Colour Doppler may help identify morphology (shown is tricuspid valve; see ‘Anatomy’ section) |  |
|
| Transgastric windows (re-attempt at all angles); CW Doppler | AV Vmax and mean gradient | Trace round modal velocity See ‘Essential parameters in the echocardiographic assessment of AS severity’ section for details |  |
| Transgastric windows (re-attempt at all angles); PW Doppler | LVOT VTI for stroke volume and AVA assessment | Trace round modal velocity See ‘Essential parameters in the echocardiographic assessment of AS severity’ section for details |  |