EFFECTIVE ORIFICE AREA

Definition:

The effective orifice area is the area at the location of a region downstream of the valve but it is

smaller as compared to the geometric area of the valve.

The area of vena contractor is called the effective orifice area, where vena contractor is the

region downstream of the valve.

How to compute EOA?

It depends on the valve we are dealing with. It can be either the aortic valve or the mitral valve.

For computing the effective orifice area we use the Gorlin Equatoin.

For Aortic valve:

The gorlin equation for aortic valve is:

Where

1
 AVA is the Aortic Valve Area relevant to the effective orifice area, it is not the actual

area of the valve and its unit is cm2.

 The P is the pressure gradient across the valve.

 44.5 is the constant that is associated with the conversion of units so the pressure gradient

can directly be put in terms of mmHg.

 MSF stands for Mean Systolic Flow and it is the ratio of stroke volume to the systolic

duration

 Tsys is the systolic duration. It is the time period per beat that is systolic.

 Stroke volume is further calculated using the cardiac output and heart rate.

For Mitral valve:

The gorlin equation for mitral valve is:

Similarly

2
  MVA stands for mitral valve area and it is not the actual area of the valve, it is related to

the effective orifice area.

 MDF is the Mean Diastolic Flow

 And 31 is the constant for unit conversion.

Application:

Solving a problem to compute the effective orifice area of a patient’s aortic valve.

Given data:

 Heart rate = HR = 72 BPM

 Cardiac output = CO = 4.5 L/min = 4500cm3/min (as we need area in cm2)

 Pressure gradient = ∆P = 30 mmHg

Solution:

Now as we know the gorlin equation for aortic valve we only have to calculate the MSF and put

it in the equation to find the area.

As we know

Now we need to find the stroke volume and the systolic duration.

For stroke volume we have:

CO = SV * HR

3
Hence

𝐶𝑂
SV =
𝐻𝑅

4500
SV =
72

SV = 62.5 cm3/Beats

Now we find the systolic duration. If we assume that the heart beat is one second long, the

systolic duration is 1/3rd and for diastolic is 2/3rd. In our case, the heart rate is 72 beats per

minute so we convert it into seconds.

72
HR = BPS
60

HR = 1.2 BPS

So the heart rate is 1.2 beats per second. So the systolic duration will be:

1 1 1
Tsys = 3 * 1.2 = 3.6 SPB

Since we need in seconds per beat so we take reciprocal of 1.2 BPS.

Now we can easily find the MSF:

𝑆𝑉 62.5
MSF = =
𝑇𝑠𝑦𝑠 1/3.6

MSF = 225 cm3/s

Now we can find the Aortic valve area easily:

4
 AVA = 0.923 cm2

Comparison:

Now we know that a normal aortic vavle has a diameter is 1.5 cm so its geometric area will be:

A = πd2/4

A = 1.77 cm2

This is the area of a normal aortic valve. To calculate the size of effective orifice area:

0.923
= * 100%
1.77

= 52%

This tells us that the effective orifice area is 52% smaller than the actual area of the aortic valve.

Conclusion:

We can say that effective orifice area is basically the vena contractor area which is the smallest

cross sectional area in the valve. For the mitral valve the procedure to find the EOA is identical,

we just use the required gorlin equation given for the mitral valve and the key difference in it is

that we have to calculate Mean Diastolic Flow instead of calculating Mean systolic flow.