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Coronary flow reserve improves after aortic valve replacement for aortic stenosis: an adenosine transthoracic echocardiography study

^a Cardiac Unit, Papworth Hospital, Cambridge, United Kingdom

View larger version (143K): [in a new window]   Figure 1 A low left parasternal short axis section through the left ventricle. The distal LAD is identified as a circular radiolucency with increased circumferential opacification lying in the anterior interventricular sulcus. IVS = interventricular septum; LAD = left anterior descending coronary artery; LV = left ventricle; RV = right ventricle.

View larger version (159K): [in a new window]   Figure 2 Low left parasternal long axis view of the anterior interventricular sulcus. Distal LAD flow is visualized as a thin red diastolic flame. LAD = left anterior descending coronary artery; LV = left ventricle.

View larger version (77K): [in a new window]   Figure 3 Doppler analysis of flow in the distal left anterior descending coronary artery before aortic valve replacement: (A) at rest and (B) during hyperemia. Note reverse systolic flow.

View larger version (80K): [in a new window]   Figure 4 Doppler analysis of flow in the distal left anterior descending coronary artery after aortic valve replacement: (A) at rest and (B) during hyperemia. Note the forward systolic flow, the reduced resting peak diastolic velocity and the increased hyperemic peak diastolic velocity.