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      Substitution of left ventricular outflow tract diameter with prosthesis size is inadequate for calculation of the aortic prosthetic valve area by the continuity equation.

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          Abstract

          It remains uncertain whether prosthetic ring size should be used interchangeably with measured left ventricular outflow tract (LVOT) diameter in the continuity equation to estimate the aortic prosthetic valve area by transthoracic Doppler echocardiography. To determine the difference in area caused by this substitution, the area of the prosthetic valve was calculated in 143 patients with aortic bioprostheses by use of the standard continuity equation with the measured LVOT diameter (LVOT method) and then with the bioprosthetic size (size method). Compared with known in vitro prosthetic valve areas, the LVOT method (r = 0.86; standard error of the estimate +/- 0.16 cm2; p < 0.001) was more accurate than the size method (r = 0.74; standard error of the estimate +/- 0.40 cm2; p < 0.001). The prosthetic valve area estimated by the size method overestimated the area estimated by the LVOT method by an average of 15% +/- 23% (p < 0.001). This difference in area between the two methods has increased with the interval since implantation of the bioprosthesis (p = 0.01). It is concluded that prosthetic size should not be used instead of LVOT diameter during calculation of aortic prosthetic valve area. This restriction is particularly important in patients with older bioprosthesis.

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          Author and article information

          Journal
          J Am Soc Echocardiogr
          Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
          0894-7317
          0894-7317
          July 1 1995
          : 8
          : 4
          Affiliations
          [1 ] Laboratory of Biomedical Engineering, Institut de recherches cliniques de Montréal, Quebec, Canada.
          Article
          S0894-7317(05)80339-6
          7546788
          66f3bfa2-ca96-4f9f-a7b3-89d04d2ce676
          History

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