Orifice-view aortography in patients with congenitally deformed aortic valves: determination of aortic valve area.

Orifice-view aortography is a contrast cineaortographic technique that allows en face viewing of the aortic valve. In this projection the anatomic configuration of the aortic valve is identified, and it is possible to planimeterize the visualized aortic valve opening and accurately determine the orifice area. Fifteen individuals with congenitally deformed aortic valves with gradients ranging from trivial (< 10 mm Hg) to surgically significant (6E 60 mm Hg) were subjected to aortic orifice area measurement by orifice-view aortography, and the area was compared with the peak systolic gradient and valve area. The results yielded a cloe correlation with the aortic valve area index as measured hydraulically or, as in three instances, directly from the surgically excised specimen (r = 0.94). A satisfactory correlation was also shown with the valve area index and the peak aortic valve gradient (r = 0.85). These observations indicate that orifice-view aortography is an accurate method for the measurement of the aortic valve orifice and may be particularly useful when hydraulic measurements are unattainable or invalid.