Aortic valve regurgitation
What is aortic valve regurgitation?
Valvular heart disease occurs when the heart's valves that control blood flow do not work properly. Valvular conditions can be present at birth or can be acquired later in life, resulting in valvular stenosis or valvular regurgitation. A regurgitant (leaking) aortic valve allows blood to flow in two directions. Oxygenated blood either flows correctly out through the aorta to the body, or it flows back into the heart’s left ventricle (lower chamber) when the ventricle relaxes.
When the blood flow is incorrect, the blood volume and pressure in the left ventricle may increase, making the heart work harder. The ventricle walls may thicken (hypertrophy), and a thickened heart muscle is less effective. Eventually, it may not supply enough blood for the body, and can lead to heart failure. Aortic regurgitation also can create bulging or weak spots that may allow an aortic aneurysm.
A symptom of mild aortic regurgitation is a heart murmur that occurs each time the left ventricle relaxes; it is detectable with a stethoscope.
Severe aortic regurgitation may cause palpitations as the left ventricle enlarges and then contracts with more force. Over time, the blood flow back-up and the resulting changes as the heart overcompensates can lead to heart failure.
Valve regurgitation, also known as valve insufficiency, occurs because a valve in the heart does not close properly, causing some blood to leak and impairing the heart's ability to pump the necessary amount to the rest of the body. Like stenosis, regurgitation is a condition that also can affect the heart's mitral, pulmonary or tricuspid valves. This condition can develop suddenly or over a long period of time.
Aortic regurgitation occurs when the aortic valve does not close tightly and blood leaks back into the heart's pumping chamber when the left ventricle relaxes. The most common cause of severe aortic regurgitation is aging, which weakens the valve tissue and can cause the valve flaps (leaflets) to become floppy. Severe aortic regurgitation often requires surgery to repair or replace the aortic valve. The most common cause of mild aortic regurgitation is high blood pressure, injury or bacterial infection of the heart valve.
To treat valvular disease (including mild aortic regurgitation), medication is often used to help maintain the heart’s normal pumping rhythm and prevent stroke. If your condition is asymptomatic, your doctor may recommend evaluation to manage the disease. However, surgical procedures are usually necessary for severe regurgitation. Heart valve surgery has become an established and effective treatment for heart valve disease. Patients can lead fuller and more active lives because of surgical techniques and products available for valve repair or replacement surgery, such as:
- Transcatheter aortic valve replacement (TAVR) – This is a revolutionary minimally invasive valve replacement procedure for patients with severe aortic stenosis who are at high risk for traditional open-heart surgery.
- Minimally invasive valve repair and/or replacement – Smaller incisions are made over the ribcage or a portion of the breastbone to enable treatment of a variety of valvular diseases. Our team includes experts in these techniques and will evaluate each patient individually to determine the risks and benefits for this approach.
- Valve repair surgery – This procedure restores the heart's original valve by reshaping it. By repairing instead of replacing the valve, surgeons can offer patients long-term benefits and advantages such as freedom from blood thinners.
- Valve replacement surgery – patients who are not candidates for valve repair, valve replacement can be recommended. During this procedure, an artificial (prosthetic) valve is used as a safe and effective treatment. The two main types of prosthetic valves used in replacement surgeries are tissue valves and mechanical valves. The type used is based on the needs of each individual patient. The surgeon will discuss options with you.