Mild to moderate aortic regurgitation

Intraoperative TEE cross-sectional images of the AoV with color Doppler flow imaging in patients with trace or mild aortic regurgitation (upper panels A and B) or mild to moderate aortic regurgitation (lower panels C and D). Regurgitant flow through the AoV is best seen in diastole in the TEE mid-esophageal AoV short-axis images (left panels A and C) and the TEE mid-esophageal AoV long-axis images (right panels B and D). The severity of aortic regurgitation is graded according to the width of the regurgitant jet in the left ventricular outflow track and the width of the vena contracta or origin of the regurgitant jet at the coaptation of the AoV cusps. Antegrade cardioplegia delivery into the aortic root is also almost always possible in patients with trace to mild aortic regurgitation and sometimes possible in patients with mild to moderate aortic regurgitation. Patients with moderate to severe aortic regurgitation are also at risk for left ventricular dilation or distension during CPB when the ascending aorta is not cross-clamped.