Flow reversal in the descending aorta: A guide to intraoperative assessment of aortic regurgitation with transesophageal echocardiography

Sutton, Damon C.; Kluger, Roman; Ahmed, Shihab; Reimold, Sharon C.; Mark, Jonathan B.

doi:10.1016/s0022-5223(94)70270-5

Cited by 32 publications

(5 citation statements)

References 29 publications

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“…Based on these findings, we speculate that plane‐based analysis underestimates flow reversal. Previous studies investigating aberrant vortex or regional flow reversal mostly used flow patterns instead of plane‐based analysis which did not detect significant flow reversal associates with vortex or helix flow. These findings and the results from our study suggest that 2D PC MRI may be suboptimal for the quantification of AR.…”

Section: Discussionmentioning

confidence: 99%

“…It has been previously shown that vortex flow in the ascending aorta (AAo) and flow reversal in the descending aorta (DAo) are related to complications such as increased AAo diameter (aneurysm), aortic valve regurgitation (AR), and stroke . Therefore, the visualization of aortic flow patterns as well as the quantification of reverse flow along the entire aorta could aid in the assessment of aortic diseases.…”

mentioning

confidence: 99%

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Voxel‐by‐voxel 4D flow MRI‐based assessment of regional reverse flow in the aorta

Shen

Schnell

Barker

et al. 2017

Magnetic Resonance Imaging

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Voxel‐by‐voxel 4D flow MRI‐based assessment of regional reverse flow in the aorta

Shen

Schnell

Barker

et al. 2017

Magnetic Resonance Imaging

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“…Increased blood flow reversal is seen in cases of AR, 22 which, in severe regurgitation, may involve the descending aorta. 23 Namely, significant AR could be one cause of retrograde flow in the descending thoracic aorta and could provoke aortic atherosclerosis. However, in a previous study, age, but not AR, was the only predictor for increased retrograde flow.…”

Section: Discussionmentioning

confidence: 99%

The association between aortic regurgitation and undetermined embolic infarction with aortic complex plaque

Kim

Cho

et al. 2017

International Journal of Stroke

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Background Retrograde embolism from the descending thoracic aorta is one possible cause of undetermined ischemic stroke. Significant aortic regurgitation can increase the amount of reversed flow in the thoracic aorta and thus is associated with an increased incidence of stroke. Aims This study aimed to examine the association between significant aortic regurgitation and undetermined embolic infarction with aortic complex plaques. Methods This study included 380 patients with undetermined embolic stroke who did not have abnormal flow such as atrial septal defect, patent foramen ovale determined by agitated saline bubble test, intracardiac thrombi on transesophageal echocardiography, atrial fibrillation, or small vessel stroke, cerebral artery, and carotid stenosis on the brain magnetic resonance imaging. The patients were divided into the complex aortic plaques group (n = 63), which was defined as having plaque with >4 mm in thickness, ulceration, or high mobility, and the no complex aortic plaques group (n = 317). Results Transesophageal echocardiography with a bubble study, brain MRI, and laboratory tests were performed for all subjects. Significant aortic regurgitation was more prevalent in patients with undetermined embolic stroke and complex aortic plaques than in patients without complex aortic plaques (adjusted OR = 4.981; 95% CI = 1.323-18.876, P = 0.028). In addition, the distribution of complex aortic plaques according to the severity of aortic regurgitation in patients with undetermined embolic stroke had a tendency toward the ascending thoracic aorta and proximal aortic arch. Conclusions Significant aortic regurgitation may affect undetermined embolic stroke in patients with complex aortic plaques.

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“…20 In our study, classic findings of AI were demonstrated and included the following: ventricular dilatation (diastolic and systolic LV dimensions); regurgitant jet from the aortic valve; and the presence of diastolic flow reversal in the descending aorta. 14,21 Diastolic flow reversal was shown to be present throughout the aorta down to below the renal arteries compared with control animals in which no native AI was present. It is this flow reversal during diastole that theoretically allows leaflets to move and function during the cardiac cycle.…”

Section: Commentmentioning

confidence: 95%

Aortic valve graft implantation in rats: a new functional model

Légaré

Nanton

Bryan

et al. 2000

The Journal of Thoracic and Cardiovascular Surgery

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Flow reversal in the descending aorta: A guide to intraoperative assessment of aortic regurgitation with transesophageal echocardiography

Cited by 32 publications

References 29 publications

Voxel‐by‐voxel 4D flow MRI‐based assessment of regional reverse flow in the aorta

Voxel‐by‐voxel 4D flow MRI‐based assessment of regional reverse flow in the aorta

The association between aortic regurgitation and undetermined embolic infarction with aortic complex plaque

Aortic valve graft implantation in rats: a new functional model

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