Imaging techniques DOPPLER ECHOCARDIOGRAPHIC ASSESSMENT OF VALVAR REGURGITATION

Improvements in outcomes for heart valve surgery, in particular mitral valve repair, have dictated a need for better assessment of valvar regurgitation. Whereas in the past surgery was delayed until the patient’s symptomatic status required intervention, patients today are often sent to the operating room while still asymptomatic or minimally symptomatic. Before committing an asymptomatic patient to open heart surgery, however, it is essential that the severity of valvar regurgitation be quantified to ensure the surgery is actually required. Doppler echocardiography has emerged as the premier way of assessing valvar regurgitation, as it allows characterisation of valve morphology, severity of regurgitation, and secondary effects, such as left ventricular dysfunction, left atrial enlargement, and pulmonary hypertension. This review will outline current methods available to the echocardiographer in assessing valvar regurgitation, focusing on simple practical ways that true quantitative information can be obtained in a clinical laboratory. Techniques that are generally applicable in all forms of valve regurgitation will be introduced first, followed by specific techniques for mitral and aortic regurgitation.