Aortic Regurgitation Flashcards
End-systolic diameter reflects
Contractility
Mild AR follow up
Every 3 years
Mod AR follow up
Every 12 months
Type 1 AR
Normal cusp motion with aortic dilatation or cusp perforation
Type 2 AR
Cusp prolapse
Type 3 AR
Cusp restriction
Specific sign for AR
Vena contracta
Supportive signs for AR
holodiastolic reversal in descending thoracic aorta, pressure half time
Quantitative measures of AR
ERO, Rvol
Severe anatomy for AR
Abnormal / flail or wide coaptation defect
Severe jet width
> = 50-60% of LVOT for central jet
Severe PHT
PHT < 200
Severe AR aorta doppler
Prominent holodiastolic reversal, especially abdominal aorta
Severe vena contracta for AR
> = 0.6 cm
Mild vena contracta for AR
< 0.3 cm
Vena contracta
Smallest diameter between flow convergence and regurgitant jet
Flow convergence
See two heads (red and blue)
Severe RVol
> = 60 ml/beat
Severe EROA
> = 0.3 cm2
Flow =
area x velocity
PISA method
Flow approaching hole organizes into shells
Same velocity within shell, higher closer to hole
Measure radius of circle where aliasing occurs (know aliasing velocity)
EROA =
flow / regurgitant velocity (use peak velocity)
Best measure for AR
vena contracta
AVR severe indications
Symptoms (I)
EF < 50% (I)
Other CV surgery (I)
EF 50% and LVESD > 50 mm or corrected >25 mm/m2 (IIa)
