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http://www.uchospitals.edu/physicians/roberto-lang.html

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Aortic Valve Replacement for Moderate Aortic Stenosis with Severe Calcification and Left Ventricualr Dysfunction—A Case Report and Review of the Literature

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http://journal.frontiersin.org/article/10.3389/fcvm.2017.00014/full

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Para aproveitar amplamente a visita de Roberto Lang ao Brasil, colocaremos em destaques os artigos que mais impactaram a área.

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Este chamou a atenção por diferentes estimativas da área aórtica.

Diferentes demais!

A pior estimativa e provavelmente com maior erro foi a realizada com o pacientes descompensado!!!

Lição para todos os ecocardiografistas!!!

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Repeat echocardiogram showed again severely reduced EF (<20%) now with qualitatively severe calcific changes of the aortic valve with a mean gradient of 17 mmHg and an aortic valve area of 0.83 cm².

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Invasive hemodynamic measurements during right and left heart catheterization demonstrated increased biventricular filling pressures (RA 12 mmHg, RV 52/12 mmHg, PA 50/30 with mean of 23 mmHg, and LVEDP 30 mmHg), mildly reduced cardiac output (PA saturation 73%, cardiac index by Fick 2.9 L/min, and cardiac index by thermodilution 2.6 L/min), and moderate aortic stenosis with peak-to-peak pressure gradient of 20 mmHg between left ventricle and ascending aorta, with a calculated aortic valve area of 1.5 cm² by the Hakki equation

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the visual estimated EF increased from 25 to 43%, and this was associated with a change of mean baseline aortic gradient of 12–19 mmHg, with a calculated aortic valve area by the continuity equation of 1.37 cm²

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