Aortic regurge Guidlines Flashcards
Mild AR 1+
Jet width: <25% of LVOT diameter
V. contra: <0.3 cm
R Volume: 30 ml
R fraction: 30%
ERO area: <0.1 cm2
- Deceleration rate <2.0 m/s2
- Pressure half time >400 ms
Mod AR 2+
Jet width: 25-65 % of LVOT diameter
V. contra: 0.3-0.6 cm
R Volume: 30-60 ml
R fraction: 30-50%
ERO area: 0.1-0.3 cm2
- Deceleration rate 2.0-3.0 m/s2
- Pressure half time 300-400 ms
Severe AR 3-4+
Jet width: >65% of LVOT diameter
V. contra: >0.6 cm
R Volume: 60 ml
R fraction: 50%
ERO area: >0.3 cm2
- Deceleration rate >3.0 m/s2
- Pressure half time <300 ms
Stage A AR
— At risk - BAV or other cong
- Asx - AV sclerosis
- disease of aortic sinuses or AA
- Hx of Rheumatic fever
- IE
Stage B AR
— Prgressive AR, Asx
- mild to mod calc
- dilated aortic sinuses
- Rheumatic valve changes
- previous IE
– Mild-Mod AR
– Normal LV function and volume
Stage C AR
— Asx, severe AR
- Calcific, BAV, Dil Ao sinuses, RH VD, IE + perfor
– Severe AR
– C1 EF > 50% mild-mod dil LBESV <50mm
–C2 EF <50% seve dil LVESV > 50 mm
indexed LVESV >25 mm/m2
Stage D AR
—Sx, severe AR
- calc, BAV, dil Ao sinuses, Rh VD, IE
–normal EF
–40-50% EF
–<40%
– mod-sev LV dilatation
– exertional dysp, angina, HF Sx
Class I (B)
- Severe, Sx AR (D)
- Severe, Asx AR (C2)
Class I (C)
– Severe AR (C-D) + other cardiac Surgery
Class IIa (B)
– Severe, Asx AR + EF >50% + severe LV dil (C2)
Class IIa (C)
– Mod, Asx AR (B) + other cardiac surgery
Class IIb (C)
– Severe, Asx (C1) + EF >50% + Prog LV dil LVEDD >65 mm if surgical risk is low
Asx stage B-C
- (B) mod + other cardiac surgery (IIa c)
- (C) sev + other cardiac surgery (I C)
- (C1) sev + EF>50% + sev LV dil LVEDD>65 mm (IIb C
- (C2) sev + EF <50% (I B)
- (C2) sev + +EF <50% + sev LV dil LVESD>50 mm (IIa B
