Aortic regurgitation surgery overview
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Aortic Insufficiency Surgery | |
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Aortic regurgitation surgery overview On the Web | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:Mohammed A. Sbeih, M.D.[2]
Related Key Words and Synonyms: Aortic valve replacement.
Overview
Aortic valve replacement is indicated in patients with severe aortic insufficiency who are either symptomatic or those who have a left ventricular end-diastolic diameter >55 mm or 25 mm/m2 or an left ventricular ejection fraction <55%.
The majority of patients with severe aortic regurgitation requiring surgery undergo aortic valve replacement instead of aortic valve repair which is sometimes preformed at highly specialized surgical centers which have appropriate technical expertise and experience in selecting potential patients.
Selecting A Mechanical Verssus a Bioprosthetic Valve
The 2006 American College of Cardiology/American Heart Association (ACC/AHA) recommendations for the choice of aortic valve [1][2]:
- If the patient is under 65 years of age and does not have a contraindication to anticoagulation then a mechanical valve is preferred.
- If the patient is ≥65 years of age and does not have risk factors for thromboembolism, then a bioprosthetic valve is reasonable
- If the patient already has a mechanical valve in the mitral or tricuspid position and already requires anticoagulation, then a mechical valve is preferred
- If the patient has active prosthetic valve endocarditis, then the valve should be replaced
- If the patient has contraindications to anticoagulation therapy regardless his or her age, then a bioprosthetic valve is indicated
References
- ↑ Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 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 (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172.
- ↑ Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G; et al. (2007). "Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology". Eur Heart J. 28 (2): 230–68. doi:10.1093/eurheartj/ehl428. PMID 17259184.