What is the traditional angiographic grading for aortic regurgitation (AR)?

Updated: Nov 19, 2018
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Aortic angiography, which may be performed during a cardiac catheterization procedure, may provide useful information regarding the severity of the patient's AR. Traditional angiographic grading is as follows:

  • Mild (1+) - A small amount of contrast enters the LV during diastole and clears with each systole

  • Moderate AR (2+) - Contrast enters the LV with each diastole, but the LV chamber is less dense than the aorta

  • Moderately severe AR (3+) - The LV chamber is equal in density to the ascending aorta.

  • Severe AR (4+) - Complete, dense opacification of the LV chamber occurs on the first beat, and the LV is more densely opacified than the ascending aorta

Assessment of the anatomy of the aorta and coronary ostia usually produces normal findings, except for the visible reflux of dye from the aortic root into the ventricle.


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