6: Cardiac valvular structure and function

Published on 02/03/2015 by admin

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Last modified 02/03/2015

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TOPIC 6 Cardiac valvular structure and function

Topic Contents

Aortic valve disease 55
Aortic stenosis 55
Aortic regurgitation 57
Mitral stenosis 58
Mitral regurgitation 61
Pulmonary stenosis 62
Pulmonary regurgitation 62
Tricuspid stenosis 63
Tricuspid regurgitation 63
Prosthetic heart valves 64
Percutaneous aortic valve bioprostheses 65

Unidirectional flow of blood through the cardiac chambers is ensured by the presence of four cardiac valves which prevent backflow. Normal structure and function of the aortic, mitral, pulmonary and tricuspid valves is described, followed by normal values for the common prosthetic valves.

Table 6.1 Normal values for mean and peak gradients and valve area for the four heart valves

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Aortic valve disease

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Aortic stenosis

It is important to remember that these peak gradients/velocities depend upon preserved left ventricular systolic function. In the setting of impaired left ventricular function, acceleration of ejected blood from the LVOT (subvalvular) to AV by greater than four times (the dimensionless

Table 6.2 Echocardiographic parameters for grading the severity of aortic stenosis

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index) is suggestive of significant aortic stenosis, and dobutamine stress echocardiography is indicated.

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Figure 6.1 Example of severe aortic stenosis demonstrated using transaortic continuous wave Doppler

Aortic regurgitation

Table 6.3

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