[Utility of the effective regurgitant orifice for the quantification of regurgitant valve lesions].

A recurring task in the work of a clinical cardiologist is to quantify the degree of mitral regurgitation in patients with valvular incompetence. Its relevance in establishing surgical indications1,2 and providing a prognosis for patients with several types of cardiovascular disease3,4 makes the attempt to improve the measurement of regurgitant flow in these patients essential. Several clinical signs and invasive/ noninvasive methods have recently been used to this end.5 The introduction of Doppler color flow mapping several years ago enabled the visualization of cardiac flow. The different types of flow found in the cardiac cavities—normal anterograde flow, shunting, and regurgitant jets—have different characteristics. From this perspective, studying regurgitant jets has obvious diagnostic and prognostic relevance. However, hopes that it would be relatively simple to measure regurgitant lesions6 with this technique soon proved false. All the methods used to measure the severity of valvular regurgitation by measuring the jet or attempts at reconstructing the jet from several planes have proven difficult.7 It is now clear that the appearance of turbulent jets depends on factors different from regurgitant flow, while the influence of instrument settings, driving pressure and so-called wall jets is well known.8 From the point of view of hydrodynamics they have intrinsically different magnitudes because the regurgitant jet includes extra Utility of the Effective Regurgitant Orifice for the Quantification of Regurgitant Valve Lesions