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 | 3-6mm | >6mm |
|
|
| Wide vena contracta [1] | PHT moderate Aoi [1] |
|---|
Jet width 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: Jet width/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
- Lancellotti P, Tribouilloy C, Hagendorff A, Moura L, Popescu BA, Agricola E, Monin JL, Pierard LA, Badano L, Zamorano JL, and European Association of Echocardiography. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). Eur J Echocardiogr. 2010 Apr;11(3):223-44. DOI:10.1093/ejechocard/jeq030 |