Detection and quantification of aortic regurgitation during aortic valvuloplasty

Abstract

The degree of aortic regurgitation, before and after balloon aortic valvuloplasty, was assessed in 32 patients, using double indicator dilution curves: a) the forward curve was obtained by dye injection into the left ventricle and sampling in the aorta; b) the regurgitant curve was obtained by dye injection in the aorta and sampling in the left ventricle. A regurgitant index (RI) was calculated by obtaining the ratio of the areas of the triangles from regurgitant and forward curves. Eight-five percent of the patients were 70 years or older. After valvuloplasty, aortic valve area increased from 0.5 +/- 0.3 cm2 to 0.7 +/- 0.3 cm2 (P = .0002) while left ventricular to aortic gradient decreased from 77 +/- 32 to 51 +/- 24 (P = .0001). RI did not significantly change in 58% of patients, increased in 25%, and decreased in 15.2%. We conclude that in most patients undergoing aortic valvuloplasty, regurgitation does not change after the procedure. In some patients it may increase significantly, and in a few it may even decrease. Indicator dilution curves technique seems to provide a sensitive, accurate, and reproducible method to detect and quantify aortic incompetence before and after valvuloplasty.