RIGHT-VENTRICULAR APICAL VIEW - A NEW WINDOW FOR DOPPLER-ECHOCARDIOGRAPHY OF AORTIC-VALVE STENOSIS

We studied a new Doppler echocardiography approach in 56 patients with valvular aortic stenosis from the right ventricular apex (AS-RV) and compared the transvalvular gradients with the results of the standard view from the left ventricular apex (AS-LV). AS-RV resulted in good or acceptable velocity curves in 59% of patients. The correlation betwee n the two apical views for the peak/mean gradients were close (r = 0.9 5/0.96). Using all typical positions for Doppler investigation of aort ic stenosis, highest peak gradients were best recorded in five cases b y AS-RV. In one woman with a narrow left ventricular cavum and severe aortic stenosis, only AS-RV yielded a technically good spectral curve. Thus, in selected patients-probably those with a small left ventricul ar cavity or an enlarged right ventricle-AS-RV may be the best window or even the only possibility in Doppler investigation of aortic valve stenosis.