Detection and quantification of aortic regurgitation during aortic valvuloplasty.
The degree of aortic regurgitation, before and after balloon aortic valvuloplasty, was assessed in 32 patients, using double indicator dilution curves: a) the forward curve was obtained by dye injection into the left ventricle and sampling in the aorta; b) the regurgitant curve was obtained by dye injection in the aorta and sampling in the left ventricle. A regurgitant index (RI) was calculated by obtaining the ratio of the areas of the triangles from regurgitant and forward curves. Eight-five percent of the patients were 70 years or older. After valvuloplasty, aortic valve area increased from 0.5 +/- 0.3 cm2 to 0.7 +/- 0.3 cm2 (P = .0002) while left ventricular to aortic gradient decreased from 77 +/- 32 to 51 +/- 24 (P = .0001). RI did not significantly change in 58% of patients, increased in 25%, and decreased in 15.2%. We conclude that in most patients undergoing aortic valvuloplasty, regurgitation does not change after the procedure. In some patients it may increase significantly, and in a few it may even decrease. Indicator dilution curves technique seems to provide a sensitive, accurate, and reproducible method to detect and quantify aortic incompetence before and after valvuloplasty.
Department of Medicine, University of Saskatchewan, Canada.
J F
JF
Lopez
M
M
Khouri
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000175:diagnosis*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000379:methods; D002404:Catheterization / Q000009:adverse effects*; D004395:Dye Dilution Technique; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged
D007208:Indocyanine Green