Current treatment of aortic regurgitation

1. Anatomy (Basso C, Lansac E, Rizzo S, Thiene G) 15
1.1. The pathology of aortic incompetence 15
1.1.1. Introduction and historical notes 15
1.1.2. Aortic root anatomy 15
1.1.3. Embryology of the aortic valve 17
1.1.4. The aorta 18
1.1.5. The pathology of the aortic root and aortic incompetence 18
1.1.6. Inflammatory disease of the aortic valve 18
1.1.6.1. Rheumatic valve disease 18
1.1.6.2. Infective endocarditis 20
1.1.6.3. Degenerative pathology of the aortic root 20
1.1.6.4. Aortic dissection 22
1.1.6.5. Rare causes of native aortic valve incompetence 23
1.1.6.6. Aetiology of aortic regurgitation in surgical pathology experience 23
1.1.6.7. Regurgitation in prosthetic aortic valves 23
1.2. Functional anatomy of the aortic valve and dynamics of aortic root 27
1.2.1. Echocardiographic anatomy of the normal aortic root 28
2. Aortic regurgitation - Epidemiology, natural history, guidelines (Iung B, Vahanian A) 32
2.1. Epidemiology and aetiologies 32
2.1.1. Degenerative aortic regurgitation 32
2.1.2. Bicuspid aortic valve disease 33
2.1.3. Rheumatic heart disease 33
2.1.4. Infective endocarditis 34
2.1.5. Inflammatory aortic diseases 34
2.1.6. Aortic dissection 34
2.1.7. Other causes of aortic regurgitation 34
2.2. Natural history 34
2.2.1. Severity of aortic regurgitation 34
2.2.2. Consequences of aortic regurgitation on the left ventricle 34
2.2.3. Enlargement of ascending aorta 35
2.3. Current guidelines 35
2.3.1. Diagnostic workup 37
2.3.2. Indications for the correction of aortic regugitation 37
2.3.3. Indications for surgery of the ascending aorta 38
2.3.4. Medical therapy 38
3. Aortic regurgitation: Role of echocardiography (Vanoverschelde J-L) 42
3.1. Echocardiographic examination of the aortic valve and root 42
3.2. Echocardiographic assessment of aortic regurgitation severity 43
3.2.1. Colour flow Doppler 43
3.2.2. Vena contracta width 44
3.2.3. The flow convergence method 44
3.2.4. Pulsed Doppler volumetric method