Clinical Implementation of Continuous-Wave Doppler: It Made All the Difference - 04/12/18

Doi : 10.1016/j.echo.2018.09.003

Randolph P. Martin, MD, FASE, FACC, FESE ^⁎
Emory University School, Atlanta, Georgia

^∗Reprint requests: Randolph P. Martin, MD, FASE, FACC, FESE, Piedmont Heart Institute, 95 Collier Road NW, Suite 2065 GA, Atlanta, GA 30309.Piedmont Heart Institute95 Collier Road NW, Suite 2065 GAAtlantaGA30309

Abstract

Today, Doppler echocardiography is central to our ability to determine cardiovascular hemodynamics, especially in valvular heart diseases, noninvasively. Continuous-wave Doppler (CWD) plays a central diagnostic role in the diagnosis and management of patients with aortic stenosis. The development and use of CWD in aortic stenosis was due to the pioneering work of Dr. Liv Hatle and her outstanding medical and engineering colleagues in Norway. The author was fortunate to be the first to use the early CWD instruments in North America. Therefore, this article highlights key lessons learned: the importance and value of key contributions made by our engineering and young cardiology and sonographer colleagues, the key importance of the independent PEDOF CWD probe as well as use of the audio signal for accurate detection of high-velocity flows, and the value of CWD for the diagnosis and management of other cardiovascular conditions.

Le texte complet de cet article est disponible en PDF.

Highlights

•	“New” technology plus astute clinical knowledge can lead to breakthroughs in care.
•	Engineers plus Clinicians make a winning team for improving patient care.
•	An independent nonimaging PEDOF CW probe is critical to accurate velocity measurements.

Le texte complet de cet article est disponible en PDF.

Keywords : PEDOF, Continous wave, Stenosis

Abbreviations : 2D, AS, CWD, LVOT, MR, PWD

Plan

Introducing CWD into cardiology practice

PWD versus CWD and advantages of close collaboration between engineers and clinicians

Lessons learned from early CWD

Advantage of the nonimaging PEDOF probe versus the imaging CWD probe

Other findings from the spectral velocity tracing in AS

Application of CWD today

Conclusion

	Dr. Martin is a member of the speakers bureaus of Medtronic Valve and Edwards Lifesciences; a member of the executive steering committee for TMVR Apollo, Medtronic; a member of the medical advisory board for CardioCare–Edwards Lifesciences; and an officer of and stockholder in Bay Labs.
	Conflicts of Interest: None.