Background: Left ventricular end diastolic pressure could be estimated collectively using various measures of mitral valve and pulmonary venous flow velocities. In patients with aortic regurgitation, the AR velocity reflects the diastolic pressure difference between the aorta and the left ventricle. We sought to predict the left ventricular end diastolic pressure by a new Doppler index as aortic regurgitation peak early to late diastolic pressure gradient ratio.Patients and Methods: Fifty three patients with at least moderate aortic regurgitation were enrolled in this study. Physical examination, electrocardiography and echocardiography were performed one day before cardiac catheterization. The severity of AR was graded according to the recommendations of American society for echocardiography. The pressure half time, aortic regurgitation early diastolic velocity , aortic regurgitation early diastolic pressure gradient , aortic regurgitation end diastolic velocity, aortic regurgitation end diastolic
Aortic valve insufficiency (avi) | Aortic valve repair. Cardiosurgery: Treatment in Geneva, Switzerland ✈. Prices on BookingHealth.com - booking treatment online!
Aortic valve insufficiency (avi) | Aortic valve repair. Cardiosurgery: Treatment in Aarau, Switzerland ✈. Prices on BookingHealth.com - booking treatment online!
My son was recently diagonsed with aortic valve insufficiency. The cardiologist says his valve is leaking in 2 places and is a grade 2-3 leak. What activity restrictions should he have for everyday t...
My son is 17 years old. He was diagnosed with mild aortic valve insufficiency when he was 14. He plays competitive basketball and is hoping for a career towards that. His last check up showed that h...
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The natural history of chronic aortic regurgitation (AR) is characterized by a series of left ventricular (LV) compensatory mechanisms. Initially, the regurgitant volume is accommodated by increases in LV end-diastolic volume and compliance and associated LV hypertrophy. However, the concomitant increased wall stress results in increased afterload and, with it, more hypertrophy. Thus, chronic AR imposes both a volume and an often underappreciated pressure load on the left ventricle (1). The natural history of the condition typically includes a long plateau phase during which LV ejection performance is maintained and patients remain asymptomatic, and it is theoretically appealing that medical intervention at this point might improve outcomes, notably the need for aortic valve replacement (AVR) and the development of heart failure.. Candidate pharmacologic agents have included calcium-channel blockers, notably nifedipine, as well as beta-blockers and drugs that target the renin-angiotensin system. ...
Background: Mild aortic regurgitation (AR) is common in older adults, often attributed to aging and is considered harmless. We studied if baseline mild AR is associated with incident HF among community-dwelling adults ≥65 years in the Cardiovascular Health Study (CHS).. Methods: In the original CHS cohort, 4895 participants were free of prevalent HF at baseline, of whom 4873 had echocardiographic data on type and grade of valvular heart disease (VHD). Of these, 372 (8%) had mild AR (AR jet height to left ventricular outflow tract diameter ratio ,24%). After excluding those with moderate (n=505), moderately severe (n=36) or severe (n=16) AR, the final sample size was 4316. We used propensity scores for mild AR, estimated for each of the 4316 participants, to match 353 (95% of 372) of those with mild AR with 1048 of those without AR, thus assembling a cohort of 1401 participants who were balanced on 56 baseline traditional cardiovascular risk factors including hypertension and blood pressure, ...
inproceedings{3036208, abstract = {Aims: Significant aortic regurgitation (AR) may cause left ventricular (LV) dilatation and heart failure. The aim was to quantify LV function in AR horses by tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2DST). Methods: Echocardiographic examinations were performed on ten healthy horses (10{\textpm}4 years;509{\textpm}58 kg) and fourteen horses with significant AR (17{\textpm}4 years;497{\textpm}93 kg). By 2DST, global radial (SR) and longitudinal (SL) strain were measured. Regional systolic radial displacement (DRS) by 2DST and velocity (VS) by TDI were measured in the interventricular septum and LV free wall. LV end-diastolic internal diameter (LVIDd) and fractional shortening (FS) were measured from a short-axis M-mode at chordal level. Results: Seven horses showed moderate AR (LVIDd range 11.0-12.7 cm), seven severe AR (LVIDd 13.3-16.9 cm). FS, SR and SL showed no significant differences. However, SL was significantly correlated with ...
Among patients with combined aortic valve disease, patients with moderate and those with severe AS at baseline did not have significantly different event-free survival rates: patients with an aortic valve area of ,1.0 cm2 had an outcome that was comparable to those with a valve area between 1.0 and 1.5 cm2 (p = 0.57). Also the degree of AR did not have prognostic value and patients with moderate AR and those with severe AR had a similar outcome (p = 0.81).. Patients with moderate AS and moderate AR had event-free survival rates of 100 ± 0%, 75 ± 10%, 24 ± 10%, and 18 ± 9% at 1, 2, 4, and 6 years, respectively, as compared to 77 ± 8%, 53 ± 9%, 42 ± 9%, and 19 ± 8% for patients with severe AS and moderate AR; 71 ± 17%, 54 ± 20%, 36 ± 20%, and 18 ± 16% for patients with moderate AS and severe AR and 76 ± 15%, 63 ± 17%, 42 ± 21%, and 21 ± 18% for patients with severe AS and severe AR (p = 0.9) (Fig. 3). However, AV-Vel was a significant predictor of outcome allowing further risk ...
TY - JOUR. T1 - Meta-Analysis of Transthoracic Echocardiography Versus Cardiac Magnetic Resonance for the Assessment of Aortic Regurgitation After Transcatheter Aortic Valve Implantation. AU - Papanastasiou, Christos A.. AU - Kokkinidis, Damianos G.. AU - Jonnalagadda, Anil K.. AU - Oikonomou, Evangelos K.. AU - Kampaktsis, Polydoros N.. AU - Garcia, Mario J.. AU - Myerson, Saul G.. AU - Karamitsos, Theodoros D.. PY - 2019/10/15. Y1 - 2019/10/15. N2 - Residual aortic regurgitation (AR) is a major complication after transcatheter aortic valve implantation (TAVI). Although the echocardiographic assessment of post-TAVI AR remains challenging, cardiac magnetic resonance (CMR) allows direct quantification of AR. The aim of this study was to review the level of agreement between 2-dimensional transthoracic echocardiography (2D TTE) and CMR on grading the severity of AR after TAVI, and determine the accuracy of TTE in detecting moderate or severe AR. Electronic databases were searched in order to ...
Assess ventricular function, volumes and LV mass (may be increased 2° LVOTO or hypertension). Measure peak CoA velocity, look for diastolic prolongation of forward flow Fig. 1. Contrast-enhanced axial CT showing a transverse fracture through the mid-portion of a coarctation stent. There is a residual moderate coarctation, and marked dilatation of the descending thoracic aorta Fig. 2. Volume rendered 3D reconstruction of a contrast-enhanced CT angiogram showing a coarctation stent with mild residual narrowing (arrow). A) b-SSFP image oblique coronal view, showing narrow jet of moderate aortic regurgitation. (b) b-SSFP images showing a 4-Ch view of a dilated left ventricle in a patient with aortic regurgitation 18 a Aortic Valve Incompetence c 500 Normal Mild AR Moderate AR 400 Severe AR b Flow volume (mL/s) 300 200 100 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 -100 Time frames -200 Fig. 2. Aortic regurgitation phase contrast velocity mapping, (a) magnitude image aortic valve, (b) phase contrast ...
Aortic valve regurgitation it affects the valve that connects the left ventricle of the heart to the aorta, responsible for distributing blood.
We describe a noninvasive method for determining end-systolic meridional and circumferential wall stress and left ventricular architecture as the ratio of muscle to cavity area. With this technique, which uses two-dimensional echocardiography and cuff-determined values for systolic blood pressure, we assessed wall stress and left ventricular architecture in 15 normal subjects and 15 asymptomatic patients with severe chronic aortic regurgitation at rest and after load manipulations with sublingual nitroglycerin. Resting end-systolic meridional and circumferential stress were increased in patients with aortic regurgitation (113.9 +/- 29 and 260 +/- 50.7 X 10(3) dynes/cm2) compared with those in normal subjects (85.6 +/- 15.4 and 214.1 +/- 28.4 X 10(3) dynes/cm2) (both p less than .01) and remained significantly greater after nitroglycerin. Meridional stress values obtained from two-dimensional echocardiographic studies correlated closely (r = .89) with values calculated from simultaneously ...
This study was undertaken to assess the contribution of Doppler echocardiography to the quantification of aortic valve regurgitation. Ultrasound examination was performed by recording aortic arch blood flow from the suprasternal notch. A non-invasive index of valve regurgitation was obtained by calculating the ratio between the maximal amplitude of forward flow during systole and the amplitude of retrograde flow during diastole measured at the onset of the R wave of the electrocardiogram. This index was compared with semiquantitative data derived from supravalvular aortography in 93 patients. In pure aortic regurgitation (67 patients) the results showed a high correlation coefficient between Doppler and angiographic estimates. In cases of associated aortic valve stenosis there were problems in the accurate estimation of systolic blood flow which led to global overestimation in general of the degree of regurgitation and considerable lack of precision in individual patients. But in general Doppler ...
This video shows a teenager with a large neo-aortic root aneurysm and severe aortic valve regurgitation following a Ross procedure, which was treated with a valve-sparing aortic root replacement. The case also highlights the intra-operative management of inadvertent aortic injury during reentry in the setting of severe aortic regurgitation ...
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Aortic regurgitation describes the leakage of the aortic valve each time the left ventricle relaxes. Learn about ongoing care of this condition.
Grading of chronic aortic regurgitation (AR) and mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR) is currently based on thresholds, which are neither modality nor quantification method specific. Accordingly, this study sought to identify CMR-specific and quantification method-specific thresholds for regurgitant volumes (RVols), RVol indexes, and regurgitant fractions (RFs), which denote severe chronic AR or MR with an indication for surgery. The study comprised patients with moderate and severe chronic AR (n = 38) and MR (n = 40). Echocardiography and CMR was performed at baseline and in all operated AR/MR patients (n = 23/25) 10 ± 1 months after surgery. CMR quantification of AR: direct (aortic flow) and indirect method (left ventricular stroke volume [LVSV] - pulmonary stroke volume [PuSV]); MR: 2 indirect methods (LVSV - aortic forward flow [AoFF]; mitral inflow [MiIF] - AoFF). All operated patients had severe regurgitation and benefited from surgery, indicated by a ...
Aortic valve regurgitation (AR) results in left ventricle (LV) volume overload (VO) leading to its dilation and hypertrophy (H). We study a rat model of severe AR induced by puncturing one or two leaflets using a catheter. Most of our studies were conducted in male animals. Recently, we started investigating if sex dimorphism existed in the AR rat model. We observed that AR females developed as much LVH as males but morphological remodeling differences were present. A head-to-head comparison of LV morphological and functional changes had never been performed in AR males (M) and females (F) using the latest modalities in cardiac imaging by echocardiography. We performed a longitudinal study to evaluate the development of LV hypertrophy caused by chronic AR in male and female rats over 6 months. Sham-operated (sham) animals were used as controls. LV diastolic volumes (EDV) increased more over 6 months in sham males than in females (38% vs. 23% for EDV, both p | 0.01). AR resulted in significant LV
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In this brief report, we describe a technique to facilitate hypothermic arrest before a redo sternotomy that is likely to require extensive dissection. This approach may be well-suited for patients with significant aortic insufficiency, as it allows control of left ventricular distention once hypothermic ventricular fibrillation ensues. The procedure entails inserting a second venous cannula through the left ventricular apex through a 7-cm left mini-thoracotomy. We used the technique successfully in a patient with a ruptured, infected ascending aortic pseudoaneurysm and severe aortic insufficiency who had undergone a previous sternotomy. ...
Indications for use of IABP - myocardial function:. (1) refractory cardiogenic shock after cardiac surgery. (2) refractory shock associated with other causes (post-operative, trauma). (3) presence of a mechanical problem with the heart. (4) heart failure after cardiac transplantation. (5) heart failure associated with viral myocarditis. Contraindications to use of IABP:. (1) aortic valve insufficiency. (2) dissecting aortic aneurysm. (3) traumatic aortic transection. (4) abdominal aortic aneurysm. Contraindications affecting insertion of IABP into femoral artery:. (1) severe atherosclerosis affecting the distal aorta, iliac and/or femoral arteries. (2) recent groin incision. Relative contraindications (poor long term prognosis or high risk complications):. (1) irreversible hepatic, renal or pulmonary failures (except transplant candidate). (2) massive stroke. (3) incurable malignant disease. (4) severe coagulopathy. (5) sepsis or severe persisting infections ...
Capillary Pulse & Syncope Symptom Checker: Possible causes include Aortic Valve Insufficiency. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.
Aortic regurgitation (AR) is a problem of moderate but increasing frequency. Current data suggest that AR of some degree affects approximately 5% to 10% of the population and increases in frequency and severity with age (1). When severe, AR gradually leads to irreversible left ventricular (LV) dysfunction, heart failure, and death; indeed, sudden death occurs in asymptomatic patients when intrinsic myocardial dysfunction is severe, even if LV ejection fraction (EF) is normal (2). Aortic valve replacement (AVR) can reliably minimize or obviate symptoms. However, management of the asymptomatic patient is a problem. In the absence of hypertension (3), no evidence supports "prophylactic" drug therapy for outcome improvement (4). Inferences from observational series have led to consensus guidelines defining indications for AVR (5), but no randomized trials ever have been performed to rigorously evaluate the life-prolonging efficacy of surgery, with resulting uncertainty and controversy. Therefore, ...
This lesion though not so common as the mitral lesion is of not infrequent occurrence in children and young adults as a sequence of acute rheumatic endocarditis.
Aortic regurgitation affects 10% of all patients with valvular heart disease. It is characterized by an abnormal backward leakage of blood from the aorta into the left ventricle (LV) during the diastolic phase of the cardiac cycle.
Müllers sign is named for Friedrich von Müller, a German physician. Müllers sign refers to pulsations of the uvula that occurs during systole and is present in patients with severe aortic insufficiency.[1] Müllers sign is caused by an increased stroke volume. ...
Also called aortic valve regurgitation, aortic regurgitation is a condition in which the aortic valve does not close properly between each heartbeat. This causes some of the blood that was being pumped out of the heart to leak back into the heart. It typically takes a prolonged period of time for a person to develop symptoms, which may include fatigue and shortness of breath.. ...
The Ross procedure offers excellent short-term outcome but the long-term durability is under debate. Reinterventions and follow-up of 100 consecutive patients undergoing Ross Procedure at our centre (1993-2011) were analysed. Follow-up was available for 96 patients (97%) with a median duration of 5.3 (0.1-17.1) years. Median age of the patient cohort was 15.2 (0.04-58.4) years with 76 males. 93% had underlying congenital aortic stenosis. Root replacement technique was applied in all. The most common valved conduits used for reconstruction of the right ventricular outflow tract were homografts (66 patients) and bovine jugular vein (ContegraR) graft (31 patients ...
Dr. Werner responded: Long course. If the ar is acute (eg due to infection or trauma), the problem is urgent. Otherwise, there is a period of many decades in which it should be monitored. Mild ar may never cause symptoms or require treatment. Serial echocardiograms done over the years will determine if the ar is leading to harm. Treatment is replacement of the aortic valve. |a href="/topics/amlodipine" track_data="{
Learn about the causes, symptoms, diagnosis & treatment of Valvular Disorders from the Professional Version of the Merck Manuals.
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... Classification & external resources ICD-10 I06., I35., Q23.1 ICD-9 395.1, 746.4 DiseasesDB 829 eMedicine med/156 
UW Medicines Regional Heart Center is enrolling patients in a clinical trial that may be the final threshold to a new standard of care for aortic-valve replacement. It is the only trial site in... ...
UW Medicines Regional Heart Center is enrolling patients in a clinical trial that may be the final threshold to a new standard of care for aortic-valve replacement. It is the only trial site in... ...
(2008) Detaint et al. JACC: Cardiovascular Imaging. Objectives: The purpose of this study was to define the link between aortic regurgitation (AR) quantitation and clinical outcome in asymptomatic patients with AR. Background: Quantitative American Society of Echocardiography (QASE) thresholds ar...
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... is an abnormality of the aortic valve that allows blood to flow backwards through the valve. The aortic valve normally allows blood to pass from the left ventricle into the aorta. From the aorta blood flows to the rest of the body. In aortic valve regurgitation, blood that is supposed to flow up through the aorta flows backward through the valve into the left ventricle of the heart.. ...
Introduction and objectives. Patients with aortic valve disease and a dilated ascending aorta are usually treated with a composite graft comprising a valve and conduit. We review here the results of treatment with an aortic root homograft as a valid alternative. Patients and method. Twenty-two consecutive patients with a mean age of 64.8 (8.8) years were studied. Mean ascending aorta dilation was 54.55 mm, aortic valve insufficiency was present in 16 patients, and a combined lesion was present in 6. In all cases a cryopreserved aortic root homograft was used to replace the aortic valve and ascending aorta. In 9 cases a Dacron conduit was used beyond the sinotubular junction to restore continuity between the homograft and the native aorta. Results. All patients survived surgery. One patient had postoperative systemic inflammatory response syndrome and one patient was re-explored for excessive bleeding. Mean duration of follow-up was 12.1 months (range 2-36 months). No patient was given ...
Previously, diagnosis was usually done through autopsy.[2] Advances in imaging technologies allow for early detection and thus ample treatment and monitoring of the affected patient. A short-axis ultrasound of the aortic valve allows for the best view of the aortic valve, and gives a clear indication of the adduction pattern of the aortic valves.[4] If an "X" shape is seen, then the patient can be diagnosed with having a quadricuspid aortic valve. A transthoracic echocardiogram (TTE) indicates if there is an aortic regurgitation, but a 3-D transesophageal echocardiogram can give a better view of the aortic valve.[7] Multidetector coronary CT angiography has been indicated as a single competent diagnostic imaging tool capable of delineating valvular anatomy, severity of regurgitation, and high risk coronary problems.[6] ...
Minimally Invasive Modified Bentall Operation in a Young Chinese Male with Severe Aortic Regurgitation Secondary to Infective Endocarditis in the Backgrou
Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation ...
This is a retrospective cohort analysis of more than 500 patients undergoing the David I procedure. They specifically looked into the outcome of 50 patients with bicuspid aortic valve undergoing this procedure. While the freedom from reoperation was not different between the two groups, the freedom from reoperation at 10 years was 79% in bicuspid valve patients. Unfortunately, the authors cannot provide markers of success for the David I procedure in patients with bicuspid valves, like geometric findings of the valve prior to reconstruction. However, these results are very encouraging for valve repair success in patients with bicuspid aortic valves.. ...
From a surgical perspective, the orientation of bioprosthetic aortic valves was never much of a question. Under direct visualization, the valve can be placed quite easily in an anatomic orientation. When the coronary ostia are located in their normal positions, separated by 120°, such orientation allows the surgeon to achieve the greatest distance between ostia and valve posts. Offsetting the valve orientation from normal makes sense only when the coronary ostia have aberrant origins, such as an 180° separation, in cases in which normal positioning of the valve would cause 1 post to lie in front of 1 of the coronary ostia.. For transcatheter valves, similar orientation becomes more difficult and is the subject of the study by Fuchs et al. (1) in this issue of JACC: Cardiovascular Interventions. The authors asked 2 questions: 1) how often are surgical and transcatheter aortic valve replacement (TAVR) valves placed in alignment with native aortic valve commissures; and 2) does the alignment ...
Eighty-five survivors who left hospital after pulmonary autograft replacement for severe aortic regurgitation have been followed critically. Five patients died in the first five years and 80 were followed for six to 11 years. Important aortic regurgitation occurred only early and was always related to technical malpositioning of one autograft cusp. Seven patients with fascial pulmonary valves had problems, requiring removal in four. There was a small (2%) morbidity from the right sided homograft and six were removed five to seven years later for progressive calcification; three of these had been irradiated. Despite a high incidence of trivial diastolic murmurs this valve replacement is still preferred for young patients without dilated aortic roots since the survivors remain well, with excellent, maintained relief of outflow obstruction, without problems from haemolysis and thromboembolism, and without deteriorating autograft function or need for anticoagulants. Histology of five autografts ...
Holubec, Tomas; Zacek, Pavel; Tuna, Martin; Dominik, Jan; Harrer, Jan; Telekes, Petr; Nedbal, Pavel; Vojacek, Jan (2013). Aortic valve repair in patients with aortic regurgitation: Experience with the first 100 cases. Cor et Vasa, 55:479-486. ...
Pouleur, Anne-Catherine ; Le Polain De Waroux, Jean-Benoît ; Pasquet, Agnes ; Watremez, Christine ; Vanoverschelde, Jean-Louis ; et. al. Successful repair of a quadricuspid aortic valve illustrated by transoesophageal echocardiography, 64-slice multidetector computed tomography, and cardiac magnetic resonance.. In: European Heart Journal (English Edition), Vol. 28, no. 22, p. 2769 (2007 ...
Aortic Regurgitation, (also known as Aortic Insufficiency; AI), is the failure of the aortic valve to close completely during diastole which causes blood to flow from the aorta back into the left ventricle. Aortic Regurgitation (AR) is a frequent cause of both disability and death due to congestive heart failure, primarily in individuals forty or older, but can also occur in younger populations.. Traditionally management of aortic regurgitation has been by aortic valve replacement, however, as has been observed in patients who have had mitral valve repair, the option of maintaining ones native aortic valve versus a replacement, either bioprosthetic or mechanical, can have added multiple benefits. The advantage of repair is the avoidance of prosthetic valve-related complications with bioprosthetic valves over 10-15 years or the need for anticoagulation with mechanical valves and the related problems of this therapy. ...
The aortic valve can become leaky due to a problem with the valve itself or with the first part of the aorta called the aortic root. Approximately half of the causes of aortic regurgitation are due to this aortic root being dilated. The cause of the aortic root dilation is idiopathic in most cases but can otherwise result from high blood pressure, ageing or a weakness in the aortic wall. In bicuspid aortic valves (from birth) the aortic valve itself can become weaker. Connective tissue disorders such as Marfans and ankylosing spondylitis are also associated with aortic regurgitation.. ...