Doppler echocardiographic evaluation of aortic regurgitation

Aortic regurgitation is diverse in presentation, perhaps pursuing a long indolent course or presenting as a catastrophic acute illness. Aortic regurgitation of any degree may be difficult to detect clinically, but echocardiographic Doppler studies afford a sensitive means of detecting and quantifying the lesion noninvasively. Pulsed-wave, continuous-wave, and color-flow Doppler modalities are complementary in the evaluation of aortic regurgitation, and all should be utilized in individual patients when surgery is contemplated. M-mode echocardiography and two-dimensional echocardiography have endured as excellent noninvasive means for evaluating the adequacy of ventricular hypertrophy in response to the insufficiency lesion. Recent interest in wall stress analysis may allow an index of ventricular performance that lends quantitative support for decisions to intervene surgically. Newer surgical options such as aortic valve homografts and pulmonary autografts may make surgery more attractive for patients considered for aortic valve replacement.