Aortic insufficiency classification of severity

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The results of a variety of diagnostic studies can be integrated to assess or classify the severity of aortic insufficiency as shown in the table below.

ACC/AHA Guidelines- Classification of the Severity of Aortic Regurgitation in Adults (DO NOT EDIT) [1]

Indicator Mild Moderate Severe
*Qualitative
Angiographic grade 1+ 2+ 3-4+
Color Doppler jet Central jet, width less than 25% of LVOT Greater than mild but no signs of severe AR Central jet, width greater than 65% LVOT
Doppler vena contracta width (cm) Less than 0.3 0.3-0.6 Greater than 0.6
*Quantitative (Cath or Echo)
Regurgitant volume (ml/beat) Less than 30 30-59 Greater than or equal to 60
Regurgitant fraction (%) Less than 30 30-49 Greater than or equal to 50
Regurgitant orifice area (cm2) Less than 0.10 0.10-0.29 Greater than or equal to 0.30
*Additional Essential Criteria
Left ventricular size Increased

AR = aortic regurgitation; cath = catheterization; echo = echocardiography; LVOT = left ventricular outflow tract.

References

  1. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (13): e1–142. doi:10.1016/j.jacc.2008.05.007. PMID 18848134.

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