From Ask Dr Wiki
Assessment of Severity
- Color flow of AI
- Severe if >60% of LVOT area
- Measure Pressure Half Time
- <250 severe
- >400 mild
- Measure Flow in descending Aorta
- Measure size of Aorta including annulus, ascending aorta, and arch
- Measure size of Vena contracta
- >6mm is severe
- Measure Pisa
- ERO > 0.4 is severe
- Measure for Diastolic Flow Reversal in aorta
- Look for Increased LV Size
|Vena Contracta Width (mm)||<0.3||0.3 to 0.60||>.6|
|Regurgitant Orifice Area||<0.2||0.2 to 0.39||>.4|
Indications for Surgery
- LVED dimensions > 7.5 cm and LVES dimensions >5.5 cm (The 55 rule)
- EF < 50%
- FC III or IV
- FC II angina
Quantification of Aortic Insufficiency by Aortography
The pigtail catheter is placed a few centimeters above the aortic root. Grading the amount of regurgitation is based on the amount of opacification of the ventricle 2 complete cardiac cycles after injection compared to that of the aortic root.
1+ Brief and incomplete ventricualar opacification. Clears rapidly.
2+ Moderate opacification of the ventricle that clears in less that 2 cycles. Never greater than aortic root opacification.
2+ AI Marfan Syndrome
3+ Opacification of the ventricle equal to aortic root opacification within 2 cycles. Delayed clearing of ventricle over several cycles.
4+ Opacification of the ventricle almost immediately that is greater than that of the aortic root with delayed clearing of the ventricle.