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{{Family tree | | | | | | | B03 | | | | | | | | | | | | | | | | | | |!| | B03= Is the patient symptomatic?}}
{{Family tree | | | | | | | B03 | | | | | | | | | | | | | | | | | | |!| | B03= Is the patient symptomatic?}}
{{Family tree | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | | |!| | }}
{{Family tree | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | | |!| | }}
{{Family tree | C01 | | | | | | | | | | C02 | | | | | | | | | | | | C03 | | |C01= Yes <br> (Stage D)| C02=No <br> (Stage C)| C03= Is the patient undergoing another surgery?}}
{{Family tree | C01 | | | | | | | | | | C02 | | | | | | | | | | | | C03 | | |C01= Yes <br> (Stage D)| C02=No <br> (Stage C)| C03= Is the patient undergoing<br> another surgery?}}
{{Family tree | |!| | | |,|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|.| | | |,|-|^|-|.| | }}
{{Family tree | |!| | | |,|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|.| | | |,|-|^|-|.| | }}
{{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= No| D07= Yes}}
{{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= No| D07= Yes}}
{{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | }}
{{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | }}
{{Family tree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E07 | | E08 | E01= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E02= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E03= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E04= AVR ([[ACC AHA guidelines classification scheme|Class IIa]])| E05= AVR ([[ACC AHA guidelines classification scheme|Class IIb]])| E06= Monitor the patient periodically| E07= Monitor the patient periodically| E08= AVR ([[ACC AHA guidelines classification scheme|Class IIa]])}}
{{Family tree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E07 | | E08 | E01= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E02= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E03= AVR ([[ACC AHA guidelines classification scheme|Class I]])| E04= AVR ([[ACC AHA guidelines classification scheme|Class IIa]])| E05= AVR ([[ACC AHA guidelines classification scheme|Class IIb]])| E06= Monitor the patient periodically| E07= Monitor the patient periodically| E08= AVR ([[ACC AHA guidelines classification scheme|Class IIa]])}}
{{Family tree/end}}
{{Family tree/end}}

Revision as of 03:03, 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
 
No
 
Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
AVR (Class I)
 
AVR (Class I)
 
AVR (Class I)
 
AVR (Class IIa)
 
AVR (Class IIb)
 
Monitor the patient periodically
 
Monitor the patient periodically
 
AVR (Class IIa)