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Transcript of the video: Closure line of aortic valve on M-Mode echocardiogram, is seen as central line, while in bicuspid aortic valve, it is an eccentric closure, nearer to one of the walls of the aorta. This eccentricity of closure of the aortic valve leaflets, can be calculated using what is known as eccentricity index.
Fetal aortic valvuloplasty is considered for fetuses with severe valvar aorticstenosis and echocardiographic features suggesting a risk of progression to hypoplastic left heart syndrome. So if progression to hypoplastic left heart syndrome can be prevented by fetal aortic valvuloplasty, that would be theoretically a great boon.
Transcatheter aortic valve replacement (TAVR) is increasing in popularity for symptomatic severe aorticstenosis. Transfemoral arterial route is the most commonly used approach for TAVR, also known as TAVI or transcatheter aortic valve implantation. No calcifications in the artery causing vascular stenosis.
The large aortic regurgitation jet can be seen as a mosaic jet in the left ventricular outflow tract anterior to the anterior mitral leaflet. A portion of the thickened aortic valve can be seen between the aorta and left ventricle. Thickening of both aortic and mitral leaflets indicate the possible etiology as rheumatic.
Coronary angiography gives a visual impression about the severity of the stenosis. But it need not imply the actual functional significance of the stenosis in terms of flow physiology. A downside of the study was that it had included lesions of 50 to 79% stenosis also. identified physiologically significant stenosis.
One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. You can see the ventricular septal defect and aortic over ride. Pulmonary stenosis, which is usually right ventricular outflow tract stenosis.
Graft material has the disadvantage that it will not grow as the baby grows and can lead to supravalvar pulmonary stenosis later, one of the delayed complications of arterial switch. This is diagrammatic representation of stenosis of pulmonary artery at the site where it has been repaired.
SMART 4 ( NCT04722250 ) studied patients with severe aorticstenosis and a small aortic annulus who underwent transcatheter aortic valve replacement (TAVR). In patients with predominantly moderate hypertriglyceridemia at elevated cardiovascular risk, olezarsen significantly reduced levels of triglycerides.
In this image, aortic regurgitation jet is seen as aliased, with part of it above the baseline and part of it below the baseline, which is known as wrap around. It is shown as a circle along the dotted Doppler line in the image, just beyond the aortic valve. Nyquist limit is half the pulse repetition frequency.
So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. When there are bulges, aortic knuckle is first mogul, main pulmonary artery segment is second mogul, and left atrial appendage is taken as the third mogul sign.
So it will not produce a true LV to aorta pullback tracing, which is required in cases like aorticstenosis. When the tip is in the left ventricle, this region will be in the aorta sometimes. For that you will have to use a catheter without side holes like this, like a multi-purpose catheter or some other catheter you have to use.
Usual structures imaged in this view are the right ventricular free wall and outflow region, interventricular septum, aorta, and aortic valve, left ventricular outflow tract, anterior and posterior mitral leaflets, left ventricular cavity, posterior wall of left ventricle and left atrium. Gradient of coarctation can be assessed in this view.
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