Chapter 15- Aortic Valve

Question 0

Name the quantitative assessment ranges for mild, moderate, or severe aortic regurgitation. Include regurgitant volume, fraction, and orifice area.

Answer 0

Mild: regurgitant volume less than 30 mL per beat, regurgitant fraction less than 30%, regurgitant orifice area less than 0.1 cm²

Moderate: regurgitant volume 30-59 mL per beat, regurgitant fraction between 30-49%, regurgitant orifice area 0.1–0.29cm².

Severe: regurgitant volume > 60 mL per beat, regurgitant fraction greater than 50%, regurgitant orifice > 0.3 cm²

Question 1

Name the qualitative data of aortic regurgitation by color Doppler. (Jet width and vena contracta criteria).

Answer 1

Mild: Central jet width < 25% of LVOT. Doppler vena contracta < 0.3 cm

Moderate: greater than mild but no signs of severe AR. Doppler vena contracta between 0.3-0.6 cm.

Severe: Central jet width >65% LVOT, plus LV size increased. Doppler vena contracta greater than 0.6 cm. Aortic flow reversal is another important parameter.

Question 2

Name the echocardiographic criteria for mild, moderate, and severe aortic stenosis.

Answer 2

The normal aortic valve opens 3 to 4 cm²

Mild: valve area >1.5 cm², mean gradient < 25 mmHg, or jet velocity 40 mm HG, or jet velocity >4.0 m/s

Question 3

The Gorland formula for aortic valve area measures the ______ area of the aortic valve, while the continuity equation measures the ______ area.

Answer 3

true anatomic; physiologic.

Question 4

What is the Gorlin formula?

Answer 4

AVA (cm²) = Cardiac output/(44.3x Heartrate X SEP square root of MVG

Question 5

What are the three classic symptoms of aortic stenosis?

Answer 5

Chest pain, syncope, heart failure.

Question 6

Calcific degeneration of the aortic valve is a result of what?

Answer 6

The process of active inflammation involving the renin-angiotensin system, lipid accumulation, with resultant calcification.

Question 7

Annual echocardiography should be performed when the aortic diameter is > ___cm in a patient with a bicuspid aortic valve.

Answer 7

4cm.

Question 8

Bicuspid aortic valves are present in ____% of the population. But occur in ___% of first degree family members. They are predominant in ____ (male/female).

Answer 8

1-2%; 9%, males.

Question 9

Surgical intervention is indicated for primary prevention in patients with a bicuspid valve if the aorta is >___ cm, or increases by >___cm in a year.

Answer 9

> 5 cm; >0.5 cm.

Question 10

If a bicuspid aortic valve requires surgical replacement, aortic replacement is also recommended if the aorta is >___cm in diameter at the time of surgery.

Answer 10

4.5 cm