Assessment of aortic regurgitation by transesophageal color Doppler imaging of the vena contracta: Validation against an intraoperative aortic flow probe
Dl. Willett et al., Assessment of aortic regurgitation by transesophageal color Doppler imaging of the vena contracta: Validation against an intraoperative aortic flow probe, J AM COL C, 37(5), 2001, pp. 1450-1455
Citations number
29
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
OBJECTIVES This study was performed to validate the accuracy of color flow
vena contracta (VC) measurements of aortic regurgitation (AR) severity by c
omparing them to simultaneous intraoperative flow probe measurements of reg
urgitant fraction (RgF) and regurgitant volume (RgV).
BACKGROUND Color Doppler imaging of the vena contracta has emerged as a sim
ple and reliable measure of the severity of valvular regurgitation. This st
udy evaluated the accuracy of VC imaging of AR by transesophageal echocardi
ography (TEE).
METHODS A transit-time how probe was placed on the ascending aorta during c
ardiac sugery in 24 patients with AR. The flow probe was used to measure Rg
F and RgV simultaneously during VC imaging by TEE. mow probe and VC imaging
were interpreted separately and in blinded fashion.
RESULTS A good correlation was found between VC width and RgF (r = 0.85) an
d RgV (r = 0.79). All six patients with VC width >6 mm had a RgF >0.50. All
18 patients with VC width <5 mm had a RgF <0.50. Vena contracta area also
correlated well with both RgF (r = 0.81) and RgV (r = 0.84). All six patien
ts with VC area >7.5 mm(2) had a RgF >0.50, and all 18 patients with a VC a
rea <7.5 mm(2) had a RgF <0.50. In a subset of nine patients who underwent
afterload manipulation to increase diastolic blood pressure, RgV increased
significantly (34 +/- 26 mi to 41 +/- 27 mi, p = 0.042) while VC width rema
ined unchanged (5.4 +/- 2.8 mm to 5.4 +/- 2.8 mm, p = 0.41).
CONCLUSIONS Vena contracta imaging by TEE color flow mapping is an accurate
marker of AR severity. Vena contracta width and VC area correlate well wit
h RgF and RgV obtained by intraoperative flow probe. Vena contracta width a
ppears to be less afterload-dependent than RgV. (J Am Coil Cardiol 2001;37:
1450-5) (C) 2001 by the American College of Cardiology.