QUANTITATION OF AORTIC-VALVE AREA IN AORTIC-STENOSIS WITH MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY - COMPARISON WITH MONOPLANE TRANSESOPHAGEAL APPROACH

The accuracy and reliability of two-dimensional monoplane and multipla ne transesophageal echocardiography (TEE) in the quantitation of aorti c valve area were compared in 54 patients with aortic stenosis. Fifty patients had aortic valve area calculated by the continuity equation a nd transthoracic Doppler echocardiography (TTE); 25 underwent cardiac catheterization. Two-dimensional echocardiograms adequate for quantita tion of aortic valve area were obtained in 21 (39%) patients with mono plane TEE and in 51 (94%) with multiplane TEE. The mean aortic valve a rea determined by both TEE methods did not differ significantly from t hat derived from TTE and catheterization. The mean difference of aorti c valve area measurements between monoplane TEE and TTE was -0.045 +/- 0.11 cm(2); that between multiplane TEE and TTE was 0.001 +/- 0.11 cm (2). Multiplane TEE provided a better correlation of aortic valve area measurements with either TTE (y = 0.97x + 0.03; r = 0.96; SEE = 0.11 cm(2)) or catheterization (y = 0.84x + 0.11; r = 0.90; SEE = 0.12 cm(2 )) than the monoplane TEE (y = 0.88x + 0.13; r = 0.83; SEE = 0.15 cm(2 ) and y = 0.41x + 0.42; r = 0.81; SEE = 0.15 cm(2)). Severe aortic ste nosis with valve orifice area of less than or equal to 0.75 cm(2) duri ng TTE examination was found by multiplane TEE with a sensitivity of 9 6% and a specificity of 96%. Thus aortic valve area can be directly an d reliably measured by two-dimensional multiplane TEE in majority of p atients with aortic stenosis.