Aortic Valve Insufficiency: Difference between revisions
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Revision as of 22:06, 18 November 2013
Quantification Aortic valve insufficiency Quantification Aortic valve insufficiency Slight Moderate Severe Jet / LVOT <25 % 25-65 % > 65% PHT > 500m / s 500 - 300m / s < 300m / s Vena contracta < 3mm - 6mm 3 > 6mm
Jetbreedte ratio relative LVOT Currently the most widely used and best documented measurement to assess the severity of aortic insufficiency , however, it has limitations in poor parasternal ( Plax ) windows and eccentric jets . Plax : jetbreedte / width left ventricular outflow -tract x 100 %
Pressure half-time ( PHT ) The pressure half-time is dependent upon both the volume and regurgitation of the diastolic function of the left ventricle ( compliance ) . However, in severe aortic valve insufficiency , the left ventricle rather " full" hit so will the pressure half-time short they cause even an end - diastolic mitral insufficiency occurred . Will also be taken so that the pressure half-time will shorten . Off when poorly tolerated aortic valve insufficiency diastolic function of the left ventricle
vena contracta The VC appears to correlate with the effective surface regurgitation ( ERO ) very well. Moreover, the VC appears to be the afterload or diastolic function of the left ventricle independently. Therefore, this seems to be the severity of aortic valve insufficiency . A very good size A VC diameter > 6mm appears to have a serious AOI . A very good sensitivity and specificity A VC < 5mm suggests a non-serious Aoi.
Pulsed - wave Doppler of flow in descending aortic Retrograde flow in Ao - descending , supra sternal immediately after subclavian artery measured by pulsed- wave Doppler . If end diastolic flow velocity : < 18 cm / s are not indicative of hemodynamically significant AOI ( grade I and II ) > 18 cm / s indicates Aol hemodynamically significant ( grade III and IV ) In severe Aoi therefore initially > 0.6 m / s TVI backflow signal > 15 cm