Show notes
In TEE Time Episode 21, we discuss properly evaluating aortic regurgitation (AR) using TEE and how findings affect perioperative care for aortic valve repair/replacement. Building on part one, the video reviews the TEE view sequence (ME AV SAX/LAX, ME ascending aorta LAX, deep TG 5-chamber or TG LAX, ME descending aorta LAX) and the six valve-evaluation categories: clinical information, 2D echo, Doppler, quantitative parameters, 3D echo, and other echo data, remembered with the “C2-DQ-3DO” mnemonic. It covers hemodynamic effects (BP/HR), leaflet anatomy/quality/function, coaptation length, annulus/LVOT/aortic measurements and surgical thresholds, bicuspid valve classification and implications, Doppler criteria (vena contracta, jet width, pressure half-time, flow reversal), limitations of PISA/stroke-volume methods, 3D vena contracta area for EROA, and assessment of MV/LV/aorta and associated bicuspid findings, emphasizing mechanism, location, and severity using ASE 2017 guidance.
00:00 AR TEE Overview
01:13 Six Pillars Framework
02:05 Valve Robot Mnemonic
03:06 Clinical Context First
03:59 2D Valve Anatomy
06:32 Annulus And Aorta Measures
09:31 Bicuspid Valve Classification
11:19 Color Doppler Clues
13:32 Spectral Doppler Metrics
15:15 Flow Reversal In Aorta
17:00 Quant Methods Limits
17:47 3D Vena Contracta Area
19:02 Other Cardiac Data
21:26 Key Takeaways Wrap Up
22:29 Next Episode And Thanks
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