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Okay,

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in this next video we're gonna discuss aortic valve calcification and calcium

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scoring. Um, so here's a example of a case, uh,

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came to us for, uh, severe aortic stenosis, uh, and prett or evaluation,

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uh, where we looked at the aortic valve calcium. Um, and, and basically,

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you know, as you know from seeing anybody with aortic stenosis,

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these patients have a lot of calcium and, uh, it's, you know,

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some people have done the work to figure out that the more severe the calcium,

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the more likely they are to have severe aortic stenosis. Um,

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so the biggest role for us in quantification of the aortic valve calcification

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is to help determine whether or not patients have severe or maybe moderate

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aortic stenosis. Uh,

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we quantify the valve calcification with a standard Agustin method from calcium

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scoring cardiac ct.

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So basically you do this study just like you would do a calcium scorer and use

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the same software that you used to calculate the calcium score, um,

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to calculate the aortic valve calcium score,

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except now you're pointing your tools, um, at the, um,

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actual valve leaflets themselves rather than at the coronary arteries. Um,

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and then you get that same AGATSTON score at the end, and that score has been,

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you know, studied. Um, and it's been found that, uh,

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patients with severe e stenosis have a higher calcium score, as I mentioned.

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And these particular numbers are the, are the ones used in the literature. Um,

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if the, it's a female patient,

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a score over 1600 suggests severe e stenosis and a male patient a score

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over 3000. Um, like I mentioned in the original, uh,

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some of the earlier videos, this valve calcification, uh, quantification is,

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it's optional. Um, you know, not everybody does it at every place. Um,

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we've started actually doing it more routinely, um, in,

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in just the past year or two. Um, but certainly, um, you know, it's a,

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a discussion to have with your interventionalists whether or not this is

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something that they would find helpful, um, and whether it's worth, you know,

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the time to, to add that additional valve calcification step to your analysis.

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Um, one other note about the valve calcification. Um,

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not only is it helpful for determining whether a patient has severe air

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stenosis, it also can, um,

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provide some information about risk of paravalvular leak. Um,

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the more calcification, the more bulky calcifications,

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particularly on the leaflet, the more likely it is to get a poor seal for that,

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um, new TAVR device.

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And a calcium score of the valve that's over 3000 has been associated with

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higher risk of leak.

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So just another thing to mention to your interventionalists and have a

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discussion when you have patients with severe utic valve calcification.