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Revision as of 03:37, 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.

Abbreviations: LVEF: left ventricular ejection fraction; LVEDD: left ventricular end diastolic diameter; LVESV: left ventricular end systolic diameter

What is the severity of the aortic regurgitation?

Severe regurgitation

❑ Vena contracta >0.6 cm
❑ Doppler jet width ≥ 65% of LVOT
❑ Regurgitant volume ≥60 mL/beat
❑ Regurgitant fraction ≥50%
❑ Effective regurgitant orifice ≥ 0.30 cm²
❑ Holodiastolic flow reversal in the proximal abdominal aorta
❑ Left ventricle dilatation

Progressive regurgitation (Stage B)

❑ Vena contracta <0.6 cm
❑ Regurgitant volume <60 mL/beat
❑ Regurgitant fraction <50%
❑ Effective regurgitant orifice <0.30 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%
AND
❑ LVESD > 50mm
(Stage C2)

❑ LVEF ≥ 50%
AND
❑ LVEDD > 65mm
AND
❑ Low surgical risk

❑ LVEF ≥ 50%
AND
❑ LVESD ≤ 50mm
AND
❑ LVEDD ≤ 65mm

No

Yes

AVR (Class I)

AVR (Class IIa)

AVR (Class IIb)

Monitor the patient periodically

AVR (Class IIa)

@@ Line 1: / Line 1: @@
 ===Indications for Aortic Valve Replacement===
 Shown below is an algorithm depicting the indications for [[aortic valve replacement]] (AVR) in chronic aortic regurgitation.
+'''Abbreviations:''' '''LVEF:''' left ventricular ejection fraction; '''LVEDD:''' left ventricular end diastolic diameter; '''LVESV:''' left ventricular end systolic diameter
 {{Familytree/start}}
@@ Line 12: / Line 14: @@
 {{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 | |!| | | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|.| | | |,|-|^|-|.| | }}
-{{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>AND <br> ❑ LVESD > 50mm <br>(Stage C2)| D04= ❑ [[LVEF]] ≥ 50% <br>AND <br> ❑ LVEDD > 65mm <br>AND <br> ❑ Low surgical risk| D05= ❑ [[LVEF]] ≥ 50% <br>AND <br> ❑ LVESD ≤ 50mm <br>AND <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>AND <br> ❑ LVESD > 50mm <br>(Stage C2)| D04= ❑ [[LVEF]] ≥ 50% <br>AND <br> ❑ LVEDD > 65mm <br>AND <br> ❑ Low surgical risk| D05= ❑ [[LVEF]] ≥ 50% <br>AND <br> ❑ LVESD ≤ 50mm <br>AND <br> ❑ LVEDD ≤ 65mm| D06= No| D07= Yes}}
 {{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/end}}

Sandbox Rim: Difference between revisions

Revision as of 03:37, 21 July 2014

Indications for Aortic Valve Replacement

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