Show notes
In Episode 20 of TEE Time, we launch the aortic valve series with Part 1 of 2 on evaluating chronic aortic regurgitation (AR) using transesophageal echocardiography (TEE), covering definitions, causes, pathophysiology, assessment goals, intervention indications, and a practical TEE view/sequence. AR (aortic insufficiency) causes inadequate forward output, LV volume/pressure overload, and potential dysfunction; acute AR (e.g., dissection, endocarditis, trauma) can rapidly raise LVEDP and cause pulmonary edema and reduced output, while chronic AR leads to eccentric hypertrophy and increased stroke volume. Mechanisms are organized by El Khoury Types I–III (normal, excessive, restricted cusp motion) with examples including STJ dilation/aneurysm, cusp perforation, prolapse/flail, rheumatic disease, and calcification. We review the 2020 AHA/ACC and selected 2025 European AVR/TAVI considerations and detail the five key TEE views for AR, including measurement tips, Doppler parameters, and holodiastolic flow reversal assessment.
00:00 Aortic Regurgitation Intro
00:50 Episode Roadmap
01:34 AR Basics and Impact
02:04 Primary vs Secondary Causes
03:42 Acute vs Chronic AR
05:13 Hemodynamic Management Tips
06:19 TEE Goals and Severity
07:16 Elkhoury Mechanism Classes
09:08 When to Replace the Valve
12:13 TEE Views and Exam Sequence
16:58 Key Takeaways and Next Episode
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