Aortic insufficiency cardiac catheterization

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

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Performance of Aortography

The pigtail catheter is placed a few centimeters above the aortic root. The image intensifier is place in the 45 degree left anterior oblique view with no cranial or caudal angulation. Usually a total of 40 to 50 cc of dye is injected with approximately 20 cc administered every second. You should tell the patient that they can expect a warm feeling throughout their body.

Grading Aortic Insufficiency

The grade of aortic insufficiency is based on the opacification of the left ventricle 2 complete cardiac cycles after injection compared to that of the aortic root.

Grade 1

Brief and incomplete ventricular opacification. Clears rapidly.

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Grade 2

Moderate opacification of the ventricle that clears in less that 2 cycles. Never greater than aortic root opacification.

<googlevideo>2835396102193538399&hl=en</googlevideo> 2+ AI Marfan Syndrome

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Grade 3

Opacification of the ventricle equal to aortic root opacification within 2 cycles. Delayed clearing of ventricle over several cycles.

<googlevideo>-7844772248158567311&hl=en</googlevideo> 3+ AI

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Grade 4

Opacification of the ventricle almost immediately that is greater than that of the aortic root with delayed clearing of the ventricle.

<googlevideo>1323435585463870537&hl=en</googlevideo> 4+ AI

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