Echocardiographic Evaluation of Chronic Aortic Regurgitation: Comparison With Cardiac Magnetic Resonance and Implications for Guideline Recommendations.

Background: Guidelines for echocardiographic evaluation of aortic regurgitation (AR) have not been validated against an independent quantitative standard.

Objectives: The aim of this study was to evaluate the accuracy of the ASE (American Society of Echocardiography) AR guidelines against cardiac magnetic resonance (CMR) and to develop simplified approaches for detection of significant AR.

Methods: Patients with AR underwent echocardiography and CMR <4 hours apart.

An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography.

A left atrial ridge is an anomaly of irregular fusion between the septum primum and septum secundum.1 Aberrant fusion of the septa results in thickened and fibrotic tissue along the region of the fossa ovalis that will occasionally protrude into the left atrium.2 The presence of a left atrial ridge has multiple clinical implications due to its close proximity to the fossa ovalis.

Paravalvular Leak.

Despite improvements and advancements in surgical technique, paravalvular leaks (PVL) continue to present a challenge when caring for patients with prosthetic valve disease. Paravalvular leaks result from dehiscence of the surgical ring from the mitral annulus. Some theories suggest that uneven distribution of collagen fibers in the mitral annulus leaves the posterior mitral annulus without a well-formed fibrous structure, which may predispose it to recurrent mechanical injury that leads to PVL.

Transcatheter mitral valve repair for primary mitral regurgitation.

The landscape of transcatheter mitral valve repair devices continues to expand, with many technologies undergoing investigation in patients with primary mitral regurgitation (MR). Transcatheter edge-to-edge repair (TEER) of the mitral valve is currently approved for management of patients with severe primary MR who are deemed to be high risk surgical candidates. The current review will focus on an integrative clinical and echocardiographic approach to guide patient selection, intra-procedural imaging guidance, and post procedural follow up in patients undergoing TEER.

Diastolic Mitral Regurgitation.

An 89-year-old female with a history of hypertension presented to the hospital with symptoms of fatigue. Her electrocardiogram (ECG) showed high-grade atrioventricular (AV) block, so a transthoracic echocardiogram was obtained to assess for structural heart abnormalities (Figure 1). Color Doppler showed mild mitral regurgitation (MR) extending into diastole.