Assessment of Regurgitant Jet Direction in Severe Aortic Regurgitation: Value of CMR Compared to Echocardiography and Cineangiography

Case Report: Severe aortic valve insufficiency is a common valvular heart disease that is characterized by left ventricular (LV) volume overload. A 40-year-old woman with a history of exertional dyspnea of four years'' duration was referred to us for evaluation. The patient''s symptoms had worsened to NYHA functional class III in the previous months. Catheterization showed severe aortic insufficiency (AI) and normal coronary arteries, but there was aneurysmal outpouching formation in the base of the LV, into which the regurgitation jet did not enter directly. The patient underwent cardiac magnetic resonance imaging (CMR), which clearly showed that the AI jet entered the LV aneurysm. CMR is now an established tool to assess aortic regurgitation and to rule out concurrent pathologies. Determination of the anatomical configuration of the aortic valve is another great merit of preoperative evaluation with CMR compared to echocardiography alone. (Iranian Heart Journal 2012; 13 (2):59-61).