**1. Introduction**

24 Echocardiography – In Specific Diseases

Jean-Louis Vanoverschelde, Eric G. Butchart, Philippe Ravaud and Alec Vahanian. What are

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Tesler, UF.; Cerin, G.; Novelli, E.; Popa, A. & Diena, M. Evolution of surgical techniques for

Subodh Verma, and Thierry G. Mesana, Mitral-Valve Repair for Mitral-Valve Prolapse. N

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the characteristics of patients with severe, symptomatic, mitral regurgitation who

echocardiographic measurements of direct effects of restrictive annuloplasty on mitral valve geometry. *Echocardiography,* Vol 27, No 8, (September 2010), pp. 931-

mitral valve repair. *Texas Heart Institute Journal*, Vol 36, No 5. (November 2009), pp.

regurgitation with two-dimensional and Doppler echocardiography. *Journal of the American Society of Echocardiography.* Vol. 16, No 7, (July 2003), pp. 777-802, ISSN Aortic stenosis (AS) is the most frequent valvular heart disease in west developed and developing countries, with prevalence between 0.02% in adults under 44 years and 3-9% in elderly over 80 years. Patients with this disease may remain asymptomatic for years, particularly in elderly with naturally limited exercise. If the patients remain untreated after they become symptomatic, the mortality at 10 years follow-up is 80-90%. Based on the etiology, mainly are three types of AS: 1) Calcific AS, which is most frequent type in adults of advanced age (2–7% of the population), 2) Congenital, which dominates in the younger patients, and 3) Rheumatic AS, which is becoming rare in developed countries.

Patient history and physical examination remain important in the diagnosis of AS. For the proper patient management, the evidence of the symptoms characteristic for AS: exertional shortness of breath, angina, dizziness, or syncope. Further diagnostic right direction is characteristic systolic murmur.

The disappearance of the second aortic sound is specific to severe AS.

Aortic valve replacement (AVR) is the only effective treatment for severe aortic AS. It is performed either isolated or concomitantly with coronary artery by-pass graft operation, which take place in almost 50% of patients with AS. The overall mortality of isolated AVR is 3-5% in patients below 70 years and 5-15% in elderly. After successful AVR, symptoms and quality of live improves significantly. The long term 10 years survival after successful AVR is very satisfied and it resulted till 75%. The most important factors that may affect the survival are old age, high NYHA functional class, associated aortic regurgitation, concomitant coronary aortic by-pass graft and atrial fibrillation.
