Aortic Stenosis

Question 1

Normal AVA

Answer 1

3-4 cm2

Question 2

Normal AV opening

Answer 2

2 cm leaflet opening

Question 3

Most common BAV fusion

Answer 3

R and L cusps

Question 4

Indications for ascending aorta surgery (class I-II)

Answer 4

Class I > 5.5 cm
Class IIa >5 cm if FH dissection, >0.5 cm/yr growth, low risk+experience
Class IIa >4.5 cm if undergoing AVR

Question 5

AV area calculation

Answer 5

AV area = (LVOT area * LVOT VTI) / AV VTI

Question 6

Discordant AVA and MG/velocity

Answer 6

Measurement error of CW doppler
LVOT measurement issues
Low flow low gradient
Paradoxical low gradient

Question 7

Good dobutamine echo response

Answer 7

Increase SV by 20%

Question 8

True AS on dobutamine

Answer 8

AVA < 1 cm,

MG rises >= 40

Question 9

Pseudoas on dobutamine

Answer 9

AVA increases > 1

MG remains <= 40

Question 10

Paradoxical low gradient AS (EF > 50%)

Answer 10

Small LVOT
Low stroke volume index (<35)
High afterload

Question 11

DI

Answer 11

LVOT velocity / AV velocity

Question 12

DI severe AS

Answer 12

<0.25

Question 13

Peak AV gradient

Answer 13

4 (peak AV velocity)^2 - 4 (peak LVOT vel)^2

Question 14

Subaortic membrane associated conditions

Answer 14

PDA
PV stenosis
Coarctation
VSD

Question 15

MDCT calcium score for severe AS men

Answer 15

> =2000

Question 16

MDCT calcium score for severe AS women

Answer 16

> =1200