aortic regurgitation    

History

- phase of disease in AR

 

phase of AR

- compensated asymptomatic AR (C1)

- decompensated asymptomatic AR (C2)

physical examination

- physical examination of AR

 

physical examination of AR

classification

- AR classification

 

AR classification

- acute AR

** native valve

** prosthetic valve

- chronic AR

pathogenesis

- pathogenesis of AR

- etiology of AR

 

pathogenesis of AR

- acute AR

- chronic AR

   

etiology of AR

- valve cusp : cusps, sinuses of Valsalva, sinotubular junction, ventriculoaortic junction

- aortic root

investigation

- preop CAG

- echocardiography

- cardiovascular magnetic resonance (CMR)

   
preop CAG   preop CAG >> cardiac catheterization

echocardiography

- indication TTE

- echocardiography ดูอะไรบ้าง

- severity of AR

- indication TTE

- echocardiography ดูอะไรบ้าง

- parameter of aortic regurgitation

- severity of AR

indication TTE

 

echocardiography ดูอะไรบ้าง

 

parameter of aortic regurgitation

- LVEF

- jet width

- vena contracta

- regurgitant volume

- regurgitant fraction

- ERO

- angiography grade

- LVESD

- LVEDD

 

severity of AR

- A = at risk of AR

- B = progressive AR

- C = asymptomatic severe AR

- D = symptomatic severe AR

cardiovascular magnetic resonance (CMR)

- indication CMR

 

indication CMR

Treatment

- medication

- surgery

   

medication

- medication จะรักษาอะไรบ้าง

 

medication จะรักษาอะไรบ้าง

- HT

- LV dysfunction

surgery

- indication surgery by recommendation by AHA

- indication surgery

- indication surgery in asymptomatic severe AR

- indication surgery in moderate AR

 

indication surgery by recommendation by AHA

+++ class I

- asymptomatic chronic severe AR

** LVEF < 50%

** other cardiac surgery

+++ class IIa

- asymptomatic chronic severe AR

** LVEF > 50% with severe LV dilatation (LVESD > 50 mm)

** other cardiac surgery

+++ class IIb

- asymptomatic chronic severe AR with LVEF > 50% with LVEDD > 65 mm)

- symptomatic chronic moderate AR

 

 

indication surgery

- progressive AR

** other cardiac surgery

- severe AR

** symptomatic severe AR

** asymptomatic severe AR with

   

indication surgery in asymptomatic severe AR

   

indication surgery in moderate AR

follow up

- how to follow up

 

how to follow up

- mild to moderate AR

- severe AR