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→VS Guideline - Table 7
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! Data element | |||
! Recording | |||
! Measurement | |||
|- | |||
! Planimetry | |||
| <ul> | |||
<li>2D parasternal short-axis view</li> | |||
<li>determine the smallest orifice by scanning from apex to base</li> | |||
<li>positioning of measurement plan can be oriented by 3D echo</li> | |||
<li>lowest gain setting to visualize the whole mitral orifice</li> | |||
</ul> | |||
| <ul> | |||
<li>contour of the inner mitral orifice</li> | |||
<li>include commissures when opened</li> | |||
<li>in mid-diastole (use cine-loop)</li> | |||
<li>average measurements if atrial fibrillation</li> | |||
</ul> | |||
|- | |||
! Mitral flow | |||
| <ul> | |||
<li>continuous-wave Doppler</li> | |||
<li>apical windows often suitable (optimize intercept angle)</li> | |||
<li>adjust gain setting to obtain well-defined flow contour</li> | |||
</ul> | |||
| <ul> | |||
<li>mean gradient from the traced contour of the diastolic mitral flow</li> | |||
<li>pressure half-time from the descending sLope of the E-wave (mid-diastole slope if not linear)</li> | |||
<li>average measurements if atrial fibrillation</li> | |||
</ul> | |||
|- | |||
! Systolic pulmonary artery pressure | |||
| <ul> | |||
<li>continuous-wave Doppler</li> | |||
<li>multiple acoustic windows to optimize intercept angle</li> | |||
</ul> | |||
| <ul> | |||
<li>maximum velocity of tricuspid regurgitant flow</li> | |||
<li>estimation of right atrial pressure according to inferior vena cava diameter</li> | |||
</ul> | |||
|- | |||
! Valve anatomy | |||
| <ul> | |||
<li>parasternal short-axis view</li> | |||
<li>parasternal long-axis view</li> | |||
<li>apical two-chamber view</li> | |||
</ul> | |||
| <ul> | |||
<li>valve thickness (maximum and heterogeneity)</li> | |||
<li>commissural fusion</li> | |||
<li>extension and location of localized bright zones (fibrous nodutes or calcification)</li> | |||
<li>valve thickness</li> | |||
<li>extension of calcification</li> | |||
<li>valve pliability</li> | |||
<li>subvalvular apparatus (chordal thickening, fusion, or shortening)</li> | |||
<li>subvalvular apparatus (chordal thickening, fusion, or shortening) Detail each component and summarize in a score</li> | |||
</ul> | |||
|} | |} | ||
==References== | ==References== | ||