Vector Flow Imaging of the Ascending Aorta in Patients with Tricuspid and Bicuspid Aortic Valve Stenosis Treated with Biological and Mechanical Implants

Kristoffer Lindskov Hansen*, Hasse Møller-Sørensen, Jesper Kjaergaard, Jørgen Arendt Jensen, Michael Bachmann Nielsen

*Corresponding author for this work

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Abstract

—Aortic valve stenosis (AS) is treated with biological prostheses (BPs) and mechanical prostheses (MPs). Vector flow imaging (VFI), an angle-independent ultrasound method, can quantify flow complexity (vector concentration (VC)) and secondary rotation (SR). Ten patients (mean age: 70.7 y) with tricuspid AS scheduled for BPs, 10 patients (mean age: 56.2 y) with bicuspid AS scheduled for MPs and 10 patients (mean age: 63.9 y) with normal aortic valves were scanned intra-operatively on the ascending aorta with VFI and conventional spectral Doppler. Bicuspid AS (peak systolic velocity (PSV): 380.9 cm/s, SR: 16.7 Hz, VC: 0.21) had more complex flow (p < 0.02) than tricuspid AS (PSV: 346.1 cm/s, SR: 17.1 Hz, VC: 0.33). Both groups had more complex and faster flow (p < 0.0001) than normal aortic valve patients (PSV: 124.0 cm/s, SR: 4.3 Hz, VC: 0.79). VC (r = 0.87) and SR (r = 0.89) correlated to PSV. After surgery, flow parameters changed (p < 0.0001) for patients with MPs (PSV: 250.4 cm/s, SR: 9.8 Hz, VC: 0.54) and BPs (PSV: 232.4 cm/s, SR: 12.5 Hz, VC: 0.61), with MPs having slower SR (p < 0.01). None of the implants had normal flow (p < 0.0001). In conclusion, VFI can provide new flow parameters for AS and implant assessment.
Original languageEnglish
JournalUltrasound in Medicine and Biology
Volume46
Issue number1
Pages (from-to)64–72
ISSN0301-5629
DOIs
Publication statusPublished - 2019

Keywords

  • Vector flow imaging
  • Vector concentration
  • Secondary rotation
  • Aortic valve stenosis
  • Bicuspid aortic valve
  • Mechanical valve

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