Table 9.
Prosthetic aortic valve regurgitation criteria (central and paravalvular)
| Parameter | Mild | Moderate | Severe |
|---|---|---|---|
| Valve structure and motion | |||
| Mechanical or bioprosthetic | Usually normal | Usually abnormal | Usually abnormal |
| Structural parameters | |||
| Left ventricular size | Normal | Normal/mildly dilated | Dilated |
| Doppler parameters (qualitative or semi-quantitative) | |||
| Jet width in central jets (% LVO diameter): colora | Narrow (≤25%) | Intermediate (26–64%) | Large (≥65%) |
| Jet density: CW Doppler | Incomplete or faint | Dense | Dense |
| Jet deceleration rate (PHT, ms): CW Dopplerb | Slow (>500) | Variable (200–500) | Steep (<200) |
| LV outflow vs. pulmonary flow: PW Doppler | Slightly increased | Intermediate | Greatly increased |
| Diastolic flow reversal in the descending aorta: | |||
| PW Doppler | Absent or brief early diastolic | Intermediate | Prominent, holodiastolic |
| Circumferential extent of paraprosthetic AR (%)c | <10 | 10–20 | >20 |
| Doppler parameters (quantitative) | |||
| Regurgitant volume (mL/beat) | <30 | 30–59 | >60 |
| Regurgitant fraction (%) | <30 | 30–50 | >50 |
aParameter applicable to central jets and is less accurate in eccentric jets.
bInfluenced by left ventricular compliance.
cFor paravalvular aortic regurgitation.
AR, aortic regurgitation; CW, continuous wave; LVO, left ventricular outflow; PW, pulsed wave.