Fully Automated Artificial Intelligence Assessment of Aortic Stenosis by Echocardiography.

Background: Aortic stenosis (AS) is a common form of valvular heart disease, present in over 12% of the population age 75 years and above. Transthoracic echocardiography (TTE) is the first line of imaging in the adjudication of AS severity but is time-consuming and requires expert sonographic and interpretation capabilities to yield accurate results. Artificial intelligence (AI) technology has emerged as a useful tool to address these limitations but has not yet been applied in a fully hands-off manner to evaluate AS.

Application of a Novel Two-Dimensional Echocardiographic Calcium Quantification Method to Assess All Severities of Aortic Stenosis.

Background: Aortic valve (AV) calcification (AVC) is a strong predictor of aortic stenosis (AS) severity. The two-dimensional AVC (2D-AVC) ratio, a gain-independent ratio composed of the average pixel density of the AV and the aortic annulus, has previously shown strong correlations with two-dimensional (2D) echocardiographic hemodynamic parameters for severe AS and AVC by cardiac computed tomography. We hypothesize that the 2D-AVC ratio correlates with hemodynamic parameters in all severities of AS.

Coronary Artery Radial Deformation and Velocity in Native and Stented Arteries.

Introduction: Coronary arteries are exposed to a variety of complex biomechanical forces during a normal cardiac cycle. These forces have the potential to contribute to coronary stent failure. Recent advances in stent design allow for the transmission of native pulsatile biomechanical forces in the stented vessel.

A Novel Two-Dimensional Echocardiography Method to Objectively Quantify Aortic Valve Calcium and Predict Aortic Stenosis Severity.

Aortic valve calcium (AVC) is a strong predictor of aortic stenosis (AS) severity and is typically calculated by multidetector computed tomography (MDCT). We propose a novel method using pixel density quantification software to objectively quantify AVC by two-dimensional (2D) transthoracic echocardiography (TTE) and distinguish severe from non-severe AS. A total of 90 patients (mean age 76 ± 10 years, 75% male, mean AV gradient 32 ± 11 mmHg, peak AV velocity 3.

Quantitative analysis of spectral Doppler clicks in assessment of aortic stenosis.

Objectives: This study was performed to evaluate an additional echocardiographic spectral Doppler marker, which would identify severe aortic stenosis (AS).

Background: Echocardiography is most commonly utilized to assess AS and has been validated against invasive measurements. However, the data obtained are not always in agreement, leaving a conundrum regarding the true severity of AS and can lead to other diagnostic procedures.

Coronary artery rotation in native and stented porcine coronary arteries.

Introduction: Coronary arteries are exposed to several complex biomechanical forces during the cardiac cycle. These biomechanical forces potentially contribute to both native coronary artery disease, development of atherosclerosis and eventual stent failure. The aim of the present study was to characterize and define coronary artery axial rotation and the effect of stent implantation on this biomechanical factor.

Should the Celiac Artery Be Used as an Anatomical Marker for the Descending Thoracic Aorta During Transesophageal Echocardiography?

Background: Transesophageal echocardiography (TEE) is a pivotal tool for diagnosis of aortic diseases. However, there are no suitable anatomical markers to describe location of disease in the descending thoracic aorta. In the past, we have used distance from the dental incisors to report location of disease, but this has no anatomical relevance.

When an unidentified foreign object appears in the inferior vena cava: recognizing the presence of TIPS stent on transthoracic echocardiographic imaging.

We describe the case of 65-year-old female with a history of hypertension, diabetes, and cirrhosis. In the subcostal view on a routine transthoracic echocardiogram (TTE), she is found to have an unidentified round prosthetic appearing object in the inferior vena cava (IVC). Upon further investigation, the object was identified as a transjugular intrahepatic portosystemic shunt (TIPS) stent, which was seen in cross section in a hepatic vein draining into the IVC.

Transesophageal echocardiography of the descending thoracic aorta: establishing an accurate anatomic marker using the celiac artery.

Objective: We performed transesophageal echocardiography (TEE) and computed tomography (CT) on patients with aortic pathology to describe a more anatomically coherent marker on TEE studies by using the celiac artery as a reference.

Background: As there are no anatomic markers for the eight-vertebrae long descending thoracic aorta, aortic disease (AD) is routinely reported as a distance from the dental incisors in TEE studies. This method does not provide an anatomically accurate location of AD relative to recognizable anatomy.

Mobile ascending aortic atheroma diagnosed by transesophageal echocardiography as source of peripheral vascular embolism.

Complex aortic atheromas are an important differential diagnosis to consider in evaluating sources of arterial embolization. Diagnosis of the embolic source is an essential first step, so treatment can then be initiated to prevent further reoccurrence. We report the case of a 36-year-old man, without significant medical history, who presented to the University of Illinois at Chicago with peripheral vascular embolism to the lower extremities.