Bioprosthetic aortic valve perivalvular leak example
From Echocardiography in ICU
Parasternal long axis view. There is a bioprosthetic aortic valve. The anterior wall of the aortic root has a double contour around an anechoic space.
There is concentric left ventricle hypertrophy, the LV function is mildly reduced.
Parasternal long axis view with color Doppler. The flow across the aortic valve is accelerated and there is aortic regurgitation (diastolic blue-yellow flow from aorta to LV). You can also see a mild mitral regurgitation (systolic blue flow from LV to LA).
Parasternal long axis view with color Doppler, zoom on the aortic valve. You can note the accelerated forward flow across the aortic valve (blue-yellow systolic flow from LV to aorta) and the moderate aortic regurgitation (blue-yellow mosaic diastolic flow from aorta to LV). At the same moment than the AR, you can see a mosaic flow between the two layers of the anterior aortic wall. You can see a communication between this flow and the AR.
There is also mild mitral regurgitation (blue systolic flow from LV to LA)
Parasternal short axis view with color Doppler, level of the aortic valve. You can see the aortic regurgitation: mosaic color diastolic flow filling the aortic valve. At the same time than the AR, there is a mosaic diastolic flow filling the echo-free space corresponding to the aortic anterior wall.
Apical 5 chamber view with Doppler color on the aortic valve. There are many artifacts throughout the color Doppler of the aortic valve. You can visualize the AR only in the last cycle of the loop. There is also a color encoded communication between aorta and RV through the tricuspid annulus.