Criteria of Ruiz et al for Paravalvular Leak for a Prosthetic Aortic Valve

Description

Ruiz et al listed grading criteria for a paravalvular leak with a prosthetic aortic valve. The authors are from multiple institutions in North America and Europe.

Patient selection: paravalvular leak for a prosthetic aortic valve

Parameters:

(1) sewing ring motion

(2) jet features

(3) percent left ventricular outflow tract (LVOT) diameter

(4) circumferential extent

(5) left ventricular size

(6) vena contracta width in mm

(7) spectral Doppler

(8) pressure half time (PHT) in milliseconds

(9) diastolic flow reversal

(10) right ventricular volume

(11) regurgitant fraction in percent

(12) effect regurgitant orifice area (EROA) in square cm

Parameter	Mild Leak	Severe Leak
sewing ring motion	normal	usually abnormal
jet features	narrow jet width, infrequent multiple, no proximal flow convergence	wide jet width, frequently multiple, proximal flow convergence
percent LVOT diameter	< 30%	>=60%
circumferential extent	<10%	>=30%
left ventricular size	normal	moderately to severely dilated
vena contracta width	< 4 mm	>= 6 mm
spectral Doppler	incomplete or faint	dense
PHT in milliseconds	> 500 ms	< 200 ms
diastolic flow reversal	absent or brief	holodiastolic
right ventricular volume	< 30 mL	>= 60 mL
regurgitant fraction	< 30%	>= 50%
EROA in square cm	< 0.1 square cm	>= 0.3 square cm

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Criteria of Ruiz et al for Paravalvular Leak for a Prosthetic Aortic Valve

Description

Specialty