All answers are directly  from the article  Jan 20, 2015 – Recommendations for echocardiographic chamber quantification were last published in 2005 by the American Society of. Echocardiography

1.How do you measure the LVOT diameter  or aortic annulus ?

  • Zoom onto the aortic valvein the PLAX view
  • Measure between the hinge points of the aortic valve leaflets in mid systole
  • Measure inner edge to inner edge
  • Do not include calcifications which are considered part of the  wall

Figure 12 Correct (A) and incorrect (B, C) measurements of the aortic annulus (double arrows). (A) Centrally positioned diameter and
central closure of leaflets. Thin lines correspond to the long axis of the ascending aorta and, orthogonally, to correct orientation of the
annular diameter. (B) Incorrect, eccentric annular measurement. The hinge points are slightly displaced upward and do not correspond
to the nadir of the cusp attachments, with incomplete opening and closing of leaflets. (C) Incorrect, oblique annular measurement.


2. How do you measure the aortic root?

  • Measurements are made from the PLAX view
  • The tubular ascending aorta is often not adequately visualized from a standard parasternal window. In
    these instances, moving the transducer closer to the sternum and/ or to a higher intercostal space may
    allow visualization of a longer portion of the ascending aorta.
  • Measure at the end of diastole (when AV is closed)
  • Make sure the tips of the aortic valve are closing in the middle of the aorta to be accurate (not oblique)
  • Measure leading edge to leading edge
  • Two-dimensional echocardiographic aortic diameter measurements are preferable to M-mode
    measurements, because cardiac motion may result in changes in the position of the M-mode cursor
    relative to the maximum diameter of the sinuses of Valsalva

3. What determines the size of the aortic root? Is a normal aortic root for a man < or > than 4 cm?

The aortic root diameter depends on the size and sex of the patient. An aortic root should always be less than 4cm irrespective of size of patient or sex