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| {{SI}}
| | #Redirect [[Aortic regurgitation surgery indications#Indications for Surgery for Acute Aortic Regurgitation]] |
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| {{CMG}}
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| '''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
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| {{Editor Help}}
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| Surgical treatment is controversial in asymptomatic patients, however has been recommended if the [[ejection fraction]] falls below 50% or in the face of progressive and severe left ventricular dilatation. For both groups of patients, surgery before the development of worse ejection fracture/LV systolic dilatation, is expected to reduce the risk of sudden death, and is associated with lower peri-operative mortality.
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| In the case of severe acute aortic insufficiency, all individuals should undergo surgery if there are no absolute contraindications for surgery. Individuals with bacteremia with aortic valve endocarditis should not wait for treatment with antibiotics to take effect, given the high mortality associated with the acute AI. In stead, replacement with an [[artificial heart valve|aortic valve]] [[homograft]] should be performed if feasible.
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| The surgical treatment of choice is [[aortic valve replacement]]. This is currently an open-heart procedure, requiring the individual to be placed on [[cardiopulmonary bypass]].
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| ===Percutaneous Aortic Valve Replacement===
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| In the close future, it is hoped that a [[percutaneous]] approach to aortic valve replacement will be feasible.
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| {| border="1" cellpadding="5" cellspacing="0" align="left"
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| |+ '''Indications for surgery for chronic severe aortic insufficiency'''<ref>{{cite journal |author= |title=ACC/AHA guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association. Task Force on Practice Guidelines (Committee on Management of Patients with Valvular Heart Disease) |journal=J. Am. Coll. Cardiol. |volume=32 |issue=5 |pages=1486–588 |year=1998 |pmid=9809971 |doi=}}</ref>
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| |-----
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| ! style="background:#efefef;" width="150px" | Symptoms
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| ! style="background:#efefef;" width="100px" | Ejection fraction
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| ! style="background:#efefef;" width="150px" | Other information
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| |-----
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| | [[New York Heart Association Functional Classification|NYHA class]] III - IV
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| | ≥ 50 % ||
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| |-----
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| | NYHA class II || ≥ 50 %
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| | Progression of symptoms or worsening parameters on echocardiography
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| |-----
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| | CHA class ≥ II [[Angina pectoris|angina]] || ≥ 50 % ||
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| |-----
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| | Regardless of symptoms || 25 - 49 % ||
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| |-----
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| | colspan="3" | Cardiac surgery for other cause (ie: [[coronary artery disease|CAD]], other valvular disease, ascending aortic aneurysm)
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| |}
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| {{-}}
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| ===Severe aortic insufficiency in patient after aortic valve replacement 1===
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| <googlevideo>-3829359717394053857&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 2===
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| <googlevideo>-1139143783733805104&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 3===
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| <googlevideo>-7501177211861270942&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 4===
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| <googlevideo>-4027195456056520519&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 5===
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| <googlevideo>3983126063629833286&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 6===
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| <googlevideo>5313961274473108141&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 7===
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| <googlevideo>-1049019986268408841&hl=en</googlevideo>
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| ===Severe aortic insufficiency in patient after aortic valve replacement 8===
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| <googlevideo>1577454681656420080&hl=en</googlevideo>
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| ==References==
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| {{reflist|2}}
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| [[Category:Cardiology]]
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| {{WH}}
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| {{WS}}
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