Aortic regurgitation in young patients

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AHA/ACC guidelines for treatment of congenital aortic insufficiency

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Class I An adolescent or young adult with chronic severe aortic insufficiency with onset of symptoms of angina, syncope, or dyspnea on exertion should receive aortic valve repair or replacement. (Level of Evidence: C) Asymptomatic adolescent or young adult patients with chronic severe aortic insufficiency with left ventricular systolic dysfunction (ejection fraction less than 0.50) on serial studies 1 to 3 months apart should receive aortic valve repair or replacement. (Level of Evidence: C) Asymptomatic adolescent or young adult patients with chronic severe aortic insufficiency with progressive left ventricualr enlargement (end-diastolic dimension greater than 4 standard deviations above normal) should receive aortic valve repair or replacement. (Level of Evidence: C) Coronary angiography is recommended before AVR in adolescent or young adult patients with aortic insufficiency in whom a pulmonary autograft (Ross operation) is contemplated when the origin of the coronary arteries has not been identified by noninvasive techniques. (Level of Evidence: C) Class IIb An asymptomatic adolescent with chronic severe aortic insufficiency with moderate aortic stenosis (peak left ventricle–to–peak aortic gradient greater than 40 mm Hg at cardiac catheterization) may be considered for aortic valve repair or replacement. (Level of Evidence: C) An asymptomatic adolescent with chronic severe aortic insufficiency with onset of ST depression or T-wave inversion over the left precordium on electrocardiogram at rest may be considered for aortic valve repair or replacement. (Level of Evidence: C)

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