Echocardiographic Assessment of Native Valve Aortic Stenosis – Guidelines Updates and Tricks of the Trade

Date: December 19, 2019

Time: 12:00PM - 01:00PM

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After a description of normal AV using anatomic and echocardiographic images (including proper aortic root and LVOT diameter measurement techniques), the various common and uncommon aortic stenosis etiologies (congenital and acquired) will be presented (diagrams, surgical, 2D and 3D echo examples). Aortic stenosis severity determination by anatomic, spectral Doppler (continuity equation) and other quantitative techniques will be discussed in detail, with an emphasis on image optimization and recognition and avoidance of the various imaging pitfalls. Although transthoracic echo is the main focus, TEE and Stress Echo as complementary imaging techniques will be integral. The other imaging modalities (cath, CCT, CMR) will be touched upon. All of this information will be directly linked to the most recent guidelines documents, including ‘from our lab’ examples of for low flow low gradient equivocal severe AS, paradoxical severe AS and others. For completion and in conclusion, key features of sub valvular (fixed and dynamic) and supravalvular aortic stenosis.

Target Audience:
This activity is designed for all cardiac sonographers and cardiovascular physicians with a primary interest, and knowledge base in the field of echocardiography; in addition, residents, researchers, clinicians, intensivists, and other medical professionals.

Learning Objectives:
At the end of this activity the viewer will better be able to:

  1. Recognize the most common causes of native aortic valve stenosis by 2D & 3D imaging
  2. Evaluate aortic stenosis severity using 2D and Spectral Doppler (continuity equation)
  3. Optimize pertinent planar and spectral Doppler images for aortic stenosis cases
  4. Understand low-flow-low gradient severe AS including paradoxical severe aortic stenosis.
  5. Understand selective use of TEE and stress echo for aortic stenosis.

Accreditation: 
The American Society of Echocardiography is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation:
The American Society of Echocardiography designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC point in the American Board of Internal Medicine's (ABIM). Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.


ARDMS, CCI and Sonography Canada recognize ASE’s certificates and have agreed to honor the credit hours toward their registry requirements for sonographers.

The American Society of Echocardiography is committed to ensuring that its educational mission and all sponsored educational programs are not influenced by the special interests of any corporation or individual, and its mandate is to retain only those authors whose financial interests can be effectively resolved to maintain the goals and educational integrity of the activity. While a monetary or professional affiliation with a corporation does not necessarily influence an author’s presentation, the Essential Areas and policies of the ACCME require that any relationships that could possibly conflict with the educational value of the activity be resolved prior to publication and disclosed to the audience. Disclosures of faculty and commercial support relationships, if any, have been indicated.

Authors:
Raymond F. Stainback, MD, FACC, FASE

Disclosures: 
According to ACCME policy, ASE implemented mechanisms to resolve all conflicts of interest prior to the planning and implementation of this activity.

The following authors reported no actual or potential conflicts of interest in relation to commercial interests for this webinar

Raymond F. Stainback, MD, FACC, FAS

The CME reviewers and ASE Staff reported no actual or potential conflicts of interest in relation to this document

Christina LaFuria; Jennifer Goss

Method of Participation: Online Only
Estimated Time to Complete this Activity: 1.0 hours
Receiving CME Credit: 
To receive online CME credit for this activity, read the full activity then complete the posttest and evaluation. A score of 70% or higher is required for successful completion. You will be able to print your CME certificate immediately following successful completion of the posttest and evaluation.

Hardware/Software Requirements:
You will need a compatible browser like Mozilla FireFox, Google Chrome or safari to view the content. Internet Explorer may not work.

Disclaimer:
This report is made available by ASE as a courtesy reference source for members. This report contains recommendations only and should not be used as the sole basis to make medical practice decisions or for disciplinary action against any employee. The statements and recommendations contained in this report are primarily based on the opinions of experts, rather than on scientifically verified data. ASE makes no express or implied warranties regarding the completeness or accuracy of the information in this report, including the warranty of merchantability or fitness for a particular purpose. In no event shall ASE be liable to you, your patients, or any other third parties for any decision made or action taken by you or such other parties in reliance on this information. Nor does your use of this information constitute the offering of medical advice by ASE or create any physician patient relationship between ASE and your patients or anyone else.

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