Bicuspid aortic stenosis echocardiogram

Overview
Two dimensional echocardiography plays an important role in the diagnosis of bicuspid aortic stenosis. Bicuspid aortic stenosis is important to diagnose because of the associated risk of endocarditis and the risk of progressive valvular stenosis.

Accuracy of Echocardiography in Determining the Number of Leaflets
Echocardiography is not that accurate in distinguishing bicuspid from tricuspid aortic valves. There is a high rate of discordance between the preoperative assessment with the post-operative pathologic findings following aortic valve repair.

Echocardiographic Findings in Bicuspid Aortic Valve Disease

 * The short axis view is useful, but doming of valve can best be seen on the parasternal long axis.
 * Echocardiographic features that are associated with a poor prognosis in asymptomatic patients and progression to a symptomatic state include moderate to severe calcification and a peak aortic velocity > 4.0 M/s.


 * Bicuspid Aortic Valve by Transesophageal Echo 1


 * Bicuspid Aortic Valve by Transesophageal Echo 2


 * Bicuspid Aortic Valve by Transesophageal Echo 3


 * Bicuspid Aortic Valve by Transesophageal Echo 4


 * Bicuspid Aortic Valve by Transesophageal Echo 5


 * Bicuspid Aortic Valve by Transesophageal Echo 6


 * Bicuspid Aortic Valve by Transesophageal Echo 7

==ACC/AHA Guidelines for Echocardiographic Evaluation and Monitoring of Asymptomatic Adults with Aortic Stenosis Secondary to Either Bicuspid or Degenerative Tricuspid Disease == {{cquote|

Class I
1. Doppler echocardiography is recommended yearly in the asymptomatic adolescent or young adult with AS who has a Doppler mean gradient greater than 30 mm Hg or a peak velocity > 3.5 m per second (peak gradient > 50 mm Hg) and every 2 years if the Doppler gradient is ≤ 30 mm Hg or the peak jet velocity is ≤ 3.5 m per second (peak gradient ≤ 50 mm Hg). (Level of Evidence: C)

2. Transthoracic echocardiography is recommended for re-evaluation of asymptomatic patients: every year for severe AS; every 1 to 2 years for moderate AS; and every 3 to 5 years for mild AS. (Level of Evidence: B)}}