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Intra-Operative Vector Flow Imaging Using Ultrasound of the Ascending Aorta among 40 Patients with Normal, Stenotic
Kristoffer Lindskov Hansen1, Hasse Møller-Sørensen2, Jesper Kjaergaard3
1Radiology Department, Rigshospitalet, Copenhagen, Denmark.
Ultrasound in Medicine & Biology
|July 30, 2016
Summary
Aortic stenosis significantly increases blood flow complexity and alters flow patterns in the ascending aorta. While valve replacement normalizes some changes, flow complexity persists, suggesting ongoing impacts of the condition.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Hemodynamics
Background:
- Aortic stenosis (AS) is a critical heart valve disease characterized by impaired blood flow through the aortic valve.
- Complex blood flow patterns and increased velocities are hallmarks of AS, impacting the ascending aorta.
- Understanding these hemodynamic alterations is crucial for diagnosis and surgical intervention.
Purpose of the Study:
- To investigate the impact of aortic stenosis on blood flow dynamics in the ascending aorta using vector flow ultrasound.
- To evaluate the effectiveness of aortic valve replacement in restoring normal blood flow patterns.
- To assess the utility of transverse oscillation (TO) for evaluating AS and guiding surgical procedures.
Main Methods:
- Employed the angle-independent vector flow ultrasound technique, transverse oscillation (TO), intra-operatively.
- Studied 20 patients with healthy aortic valves and 20 patients with aortic stenosis.
- Acquired flow data from the ascending aorta before and after aortic valve replacement.
Main Results:
- Aortic stenosis significantly increased flow complexity (p < 0.0001) and induced systolic backflow (p < 0.003), while reducing systolic jet width (p < 0.0001).
- Post-valve replacement, systolic backflow and jet width normalized (p < 0.52 and p < 0.22, respectively).
- However, elevated flow complexity persisted after surgery (p < 0.0001), and all measured parameters correlated with peak systolic velocity.
Conclusions:
- Aortic stenosis profoundly alters blood flow in the ascending aorta, characterized by increased complexity and specific flow disturbances.
- Aortic valve replacement effectively normalizes some hemodynamic changes, such as systolic backflow and jet width.
- Transverse oscillation shows promise as a valuable tool for assessing aortic stenosis severity and optimizing surgical outcomes in valve replacement procedures.
Keywords:
Aortic valve stenosisFlow complexityIntraoperative ultrasoundSecondary flowSystolic backflowTransverse oscillationVector flow imaging
