@KemalogluOz I like to use these two slides to demonstrate the different physiology states of normal flow and low flow

Our case has been published in @CASEfromASE . Such a supportive group to write with. Thanks for the opportunity @VLSorrellImages Thanks to all the authors #MQHealth @Macquarie_Uni #echofirst

@AnastasiaSMihai Hope you are okay 💜

@Obisht @Becho2106 @echoguru @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi I know of this with prosthetic valves , is this something you us for native valves too ?

@alex1708ander @KemalogluOz @Becho2106 @echoguru @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi There was a discrepancy between total , total - 39 ml and would therefore index as low SV . Forward - indexed at 70 ml/m2 . Does your lab use the total SV , if you have a case of high LVOT Vel ?

@alex1708ander @KemalogluOz @Becho2106 @echoguru @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi Coronaries are clean , no significant disease

@KemalogluOz @Becho2106 @echoguru @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi 70 ml/m2 , BSA - 1.58

@BeardedHeartDoc @Becho2106 @echoguru @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @kaznegishi 2.9 m/sec was the highest gradient from the SSN . interesting use of contrast , I did not know that you can do that .

@kaznegishi @Becho2106 @echoguru @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc Thanks Kaz . It was really hard to seperate the MR signal from the late peaking intra cavity . I attempted it several times. What do you make of the Agaston score of 2800 . Here is the valve on CT and you can appreciate how it’s the NCC is so calcified

@Becho2106 @echoguru @BeardedHeartDoc @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @kaznegishi GLS - 19%

@amin_mulji @Becho2106 @echoguru @KemalogluOz @sturwohld @RobChamb87 @NMerke @echo_stepbystep @BeardedHeartDoc @kaznegishi Agaston score of 2800 . Here is the valve on CT

First thoughts - high LVOT vel - without the septal bulge could this be underlying low flow ? LVOTd measured and predicted = 2.1 cm , BSA - 1.58 Normal LVEF and GLS AVA - 1.95 cm2 . Or is this just not true moderate or severe AS ?

@Becho2106 @echo_batman @echoguru @sturwohld @dr_benoy_n_shah @iamritu @NMerke Case 1 - AV Vmax is the same as baseline , but was high flow state at the time of baseline . SVi - not as high now Case 2 - all numbers higher on comparison and CWD now parabolic

@alex1708ander Ascending aorta - 3.6 cm/ 1.88 cm/m2

@echo_batman @echoguru @sturwohld @Becho2106 @dr_benoy_n_shah @iamritu @NMerke Here I have used two methods, one using duration - 112 ms, and the other using the time to peak - 120 ms

@iamritu @JournalASEcho @SNagueh @DermotPhelanMD @rajdoc2005 @purviparwani @NMerke @jct_ucb @NadeenFaza @echo_stepbystep @eromerodorta Thank you