Aortic Insufficiency

Question 1

TEE indications in the workup of AI

Answer 1

• Pts with moderate or severe AR and suboptimal TTE images or a discrepancy between clinical and
  *

Question 2

Treatment of hypertension in patients with AI

Answer 2

In asymptomatic patients with chronic AR (Stages B and C), treatment of hypertension (systolic blood pressure >140 mmHg) is recommended (1–3).

2. In patients with severe AR who have symptoms and/or LV systolic dysfunction (Stages C2 and D) but a prohibitive surgical risk, GDMT for reduced LVEF with ACE inhibitors, ARBs, and/or sacubitril/valsartan is recommended (4).

Question 3

Echocardiogram - severe AI (all)

Answer 3

1. Doppler jet width > 65% of LVOT
2. Vena contracta >0.6 cm
3. Holodiastolic flow reversal in the proximal abdominal aorta
4. Regurgitant volume > 60 mL/beat
5. Regurgitant fraction > 50%
6. ERO >0.3 cm2

Question 4

Severe AI - Echocardiography -

Doppler jet width?

Answer 4

Severe AI - Echocardiography -

Doppler jet width > 65% of LVOT

Question 5

Severe AI - Echocardiography -

Vena contracta?

Answer 5

Severe AI - Echocardiography -

Vena contracta >0.6 cm

Question 6

Severe AI - Echocardiography -

flow reversal?

Answer 6

Holodiastolic flow reversal in the proximal abdominal aorta

Question 7

Severe AI on Echocardiography -

Regurgitant volume?

Answer 7

Severe AI on Echocardiography -

Regurgitant volume > 60 mL/beat

Question 8

Severe AI on Echocardiography -

Regurgitant fraction?

Answer 8

Severe AI on Echocardiography -

Regurgitant fraction > 50%

Question 9

Severe AI on Echocardiography -

ERO ?

Answer 9

Severe AI on Echocardiography -

ERO >0.3 cm2