Valvular Disease

Question 1

Indications for surgical management - Aortic Regurgitation

Answer 1

Severe AR - symptomatic OR asymptomatic (LVEF <55% or awaiting cardiac surgery) - level 1
Moderate AR - awaiting cardiac surgery -level 2a

Question 2

Signs of severe AR

Answer 2

• Abnormal/flail or wide coaptation defect
• Dilated LV
• Regurgitant volume >60mL
• Regurgitant fraction >50%
• Large jet width in LVOT
• Large flow convergenance (velocity of flow before valve)
• Steep Jet deceleration rate or pressure half-time (PHT) <200 (pressure gradient across the valve)
• Prominent holodiastolic reversal (backflow in the aorta during diastole)