20. How to Evaluate Aortic Regurgitation using TEE - Part 1 of 2 - TEE for Aortic Valve Surgery

In Episode 20 of TEE Time, we launch the aortic valve series with Part 1 of 2 on evaluating chronic aortic regurgitation (AR) using transesophageal echocardiography (TEE), covering definitions, causes, pathophysiology, assessment goals, intervention indications, and a practical TEE view/sequence. AR (aortic insufficiency) causes inadequate forward output, LV volume/pressure overload, and potential dysfunction; acute AR (e.g., dissection, endocarditis, trauma) can rapidly raise LVEDP and cause pulmonary edema and reduced output, while chronic AR leads to eccentric hypertrophy and increased stroke volume. Mechanisms are organized by El Khoury Types I–III (normal, excessive, restricted cusp motion) with examples including STJ dilation/aneurysm, cusp perforation, prolapse/flail, rheumatic disease, and calcification. We review the 2020 AHA/ACC and selected 2025 European AVR/TAVI considerations and detail the five key TEE views for AR, including measurement tips, Doppler parameters, and holodiastolic flow reversal assessment.   00:00 Aortic Regurgitation Intro 00:50 Episode Roadmap 01:34 AR Basics and Impact 02:04 Primary vs Secondary Causes 03:42 Acute vs Chronic AR 05:13 Hemodynamic Management Tips 06:19 TEE Goals and Severity 07:16 Elkhoury Mechanism Classes 09:08 When to Replace the Valve 12:13 TEE Views and Exam Sequence 16:58 Key Takeaways and Next Episode   #TEE #Echocardiography #Anesthesia #Cardiology #CriticalCare #EmergencyMedicine #Sonographer #CardiacSurgery #FOAMed #POCUS #Ultrasound #Anesthesiology #Perioperative #CardiacAnesthesia #AnesthesiaPodcast #Anesthesiology #Echo #Surgery #AdvancedTEE #PerioperativeTEE #TTE #Sonography #TEETime #TransesophagealEchocardiography #BasicPTE #AdvancedPTE #PTEeXAM #ICU   DISCLAIMER: This podcast provides recommendations intended for educational purposes only and should not be used as the sole basis for making medical decisions. The information reflects expert opinions rather than scientifically-verified data, and no express or implied warranties are made regarding its accuracy, completeness, or fitness for any particular purpose. Listeners are encouraged to verify all information independently and consult additional reliable sources. Neither the authors, publishers, nor any parties involved assume responsibility for any errors, omissions, or outcomes resulting from the use of this material. All non-original material featured in this podcast is either used with explicit permission from the copyright owner or is believed to fall under the Fair Use provisions of U.S. copyright law for purposes such as education, commentary, and criticism. If you believe any material has been used improperly, please contact the author directly so the matter can be promptly reviewed and addressed.