Assessment of Aortic valve area by Three dimensions echocardiography Versus two dimensions echocardiography parameters in patients with Aortic valve stenosis.

Background: Accurate assessment of aortic valve area (AVA) is essential for grading aortic valve stenosis and guiding clinical management. Conventional transthoracic echocardiography (TTE) using the continuity equation is widely used; however, geometric assumptions may affect accuracy. Three-dimensional transesophageal echocardiography (3D TEE) allows direct anatomical planimetry and may improve AVA assessment. Aim: To assess aortic valve area using three-dimensional transesophageal echocardiography (3D TEE) planimetry and compare it with conventional two-dimensional transthoracic echocardiographic parameters in patients with aortic valve stenosis. Methods: This prospective cross-sectional analytic study included 50 patients with aortic valve stenosis. Included 50 patients with aortic valve stenosis. All patients underwent conventional two-dimensional TTE with Doppler evaluation, including calculation of AVA using the continuity equation, followed by 3D TEE with direct AVA planimetry. Echocardiographic parameters were compared, and correlations between AVA measurements and hemodynamic indices were analyzed. Results: The mean age of patients was 72.5 ± 4.56 years. Three-dimensional TEE planimetry classified 68% of patients as having severe aortic stenosis and 32% as moderate. AVA measured by 3D TEE showed a very strong positive correlation with AVA calculated by TTE (r = 0.916, p < 0.001), with no significant difference between the two methods (p = 0.361). AVA by 3D TEE correlated strongly with Doppler-derived parameters, including mean and peak pressure gradients, peak aortic velocity, and dimensionless velocity index (all p < 0.001). No significant correlations were found between AVA and age, left ventricular dimensions, or ejection fraction. Conclusion: Three-dimensional TEE planimetry provides a reliable anatomical assessment of aortic valve area and shows strong agreement with conventional transthoracic echocardiography using the continuity equation. It may serve as a complementary tool in selected patients; however, the absence of an external reference method limits conclusions regarding absolute diagnostic accuracy.