Presentation
Aortic valve replacement, complains of not hearing the click sound of his valve anymore; hypotension.
Patient Data
severe aortic regurgitation, pressure half time (PHT): 164 ms
holodiastolic flow reversal in the descending aorta as seen on the suprasternal view with an increased end-diastolic velocity of 21 cm/s and a velocity-time integral (VTI) of 26 cm
Case Discussion
Holodiastolic flow reversal correlates with increasing severity of aortic insufficiency and may indicate at least moderate aortic regurgitation. An end-diastolic velocity >20 cm/s and a velocity-time integral (VTI) of the retrograde flow >15 cm, suggests severe aortic regurgitation. The sample volume for pulsed wave Doppler is placed at the aortic isthmus (distal to the subclavian artery) to obtain the measurement in the proximal descending thoracic aorta.
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