Aortic Valve Insufficiency: Difference between revisions
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Quantification Aortic valve insufficiency | ==Quantification Aortic valve insufficiency== | ||
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Slight Moderate Severe | ! | ||
Jet / LVOT <25 % 25-65 % > 65% | !Slight | ||
PHT > 500m / s 500 - 300m / s < 300m / s | !Moderate | ||
Vena contracta < 3mm - 6mm | !Severe | ||
|- | |||
|align="center"|Jet/LVOT | |||
|align="center"|<25% | |||
|align="center"|25-65% | |||
|align="center"|>65% | |||
|- | |||
|align="center"|PHT | |||
|align="center"|>500m/s | |||
|align="center"|500-300m/s | |||
|align="center"|<300m/s | |||
|- | |||
|align="center"|Vena contracta | |||
|align="center"|<3mm | |||
|align="center"|3-6mm | |||
|align="center"|>6mm | |||
|} | |||
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|[[Image:AoIVC.jpg|350px]] | |||
|[[Image:AoIPHT.jpg|350px]] | |||
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!Wide vena contracta <cite>1</cite> | |||
!PHT moderate Aoi <cite>1</cite> | |||
|} | |||
==Jetbreedte ratio relative LVOT== | ==Jetbreedte ratio relative LVOT== | ||
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In severe Aoi therefore initially > 0.6 m / s | In severe Aoi therefore initially > 0.6 m / s | ||
TVI backflow signal > 15 cm | TVI backflow signal > 15 cm | ||
==References== | |||
#1 pmid=20375260 | |||
Revision as of 16:28, 25 November 2013
Quantification Aortic valve insufficiency
| Slight | Moderate | Severe | |
|---|---|---|---|
| Jet/LVOT | <25% | 25-65% | >65% |
| PHT | >500m/s | 500-300m/s | <300m/s |
| Vena contracta | <3mm | 3-6mm | >6mm |
|
|
| Wide vena contracta [1] | PHT moderate Aoi [1] |
|---|
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
References
- 1 pmid=20375260