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{{Family tree | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | A01= }}
{{Family tree | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | A01= What is the severity of the aortic regurgitation?}}
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{{Family tree | | | | | | | B01 | | | | | | | | | | | | | | | | | | B02 | B01= <div style="float: left; text-align: center; width:12em"> '''Severe regurgitation''' </div> <div style="float: left; text-align: left; width: 15em; line-height: 150%"> <br> ❑ Vena contracta >0.6 cm <br> ❑ Jet/LVOT ≥ 65% <br> ❑ Regurgitant volume ≥60 mL/beat <br> ❑ Regurgitant fraction ≥50% <br> ❑ Effective regurgitant orifice ≥ 0.30 cm² <br> ❑  Holodiastolic flow reversal in the proximal abdominal aorta </div>| B02= <div style="float: left; text-align: center; width:18em">'''Progressive regurgitation''' ([[Aortic regurgitation stages|Stage B]]) </div> <div style="float: left; text-align: left; line-height: 150%"> '''Mild''' <br> ❑ Vena contracta <0.3 cm <br> ❑ Jet/LVOT <25% <br> ❑ Regurgitant volume <30 mL/beat <br> ❑ Regurgitant fraction <30% <br> ❑ Effective regurgitant orifice <0.10 cm² </div>}}
 
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{{Family tree | | | | | | | B03 | | | | | | | | | | | | | | | | | | |!| | B03= Is the patient symptomatic?}}
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{{Family tree | C01 | | | | | | | | | | C02 | | | | | | | | | | | | C03 | | |C01= Yes <br> (Stage D)| C02=No <br> (Stage C)| C03= Is the patient undergoing another surgery?}}
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{{Family tree | |!| | | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | D01= LVEF<50% <br> (Stage C2)|D02=The patient is undergoing another surgery| D03= LVEF ≥50% <br> LVESD >50mm (Stage C2)| D04= LVEF ≥50% <br> LVEDD >65mm <br> Low surgical risk| D05= LVEF ≥50% <br> LVESD ≤50mm <br> LVEDD ≤65mm| D06= | D07= }}
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Revision as of 02:44, 21 July 2014

Indications for Aortic Valve Replacement

Shown below is an algorithm depicting the indications for aortic valve replacement (AVR) in chronic aortic regurgitation.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
What is the severity of the aortic regurgitation?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Severe regurgitation

❑ Vena contracta >0.6 cm
❑ Jet/LVOT ≥ 65%
❑ Regurgitant volume ≥60 mL/beat
❑ Regurgitant fraction ≥50%
❑ Effective regurgitant orifice ≥ 0.30 cm²
❑ Holodiastolic flow reversal in the proximal abdominal aorta
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Progressive regurgitation (Stage B)
Mild
❑ Vena contracta <0.3 cm
❑ Jet/LVOT <25%
❑ Regurgitant volume <30 mL/beat
❑ Regurgitant fraction <30%
❑ Effective regurgitant orifice <0.10 cm²
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Is the patient symptomatic?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
(Stage D)
 
 
 
 
 
 
 
 
 
No
(Stage C)
 
 
 
 
 
 
 
 
 
 
 
Is the patient undergoing another surgery?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LVEF<50%
(Stage C2)
 
The patient is undergoing another surgery
 
LVEF ≥50%
LVESD >50mm (Stage C2)
 
LVEF ≥50%
LVEDD >65mm
Low surgical risk
 
LVEF ≥50%
LVESD ≤50mm
LVEDD ≤65mm