Aortic Valve Regurgitation: Deciding About Surgery - Topic Overview
The major decision in treating
aortic valve regurgitation is whether to have aortic
valve replacement surgery and, if so, when to do it.
Your doctor will check the severity of your condition. Your doctor will also check your overall health to see if surgery is too risky for you. Then you and your doctor will weigh the benefits of surgery against the risks for you.
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surgery is usually only done if regurgitation is severe and in danger of
doing irreparable damage to your heart. The risk of surgery is justified if the
regurgitation is severe enough to threaten the health of your heart or your
Your doctor might recommend valve replacement surgery if you
have severe regurgitation and one of the following conditions:1
Your left ventricle enlarges to more than 55
millimeters at rest.
You are going to have another open-heart
surgery such as
Your doctor may recommend that you have surgery even if you don't
have symptoms, because symptoms typically only occur after the condition has
progressed to the point that it has already damaged the heart.
When should I have surgery?
The timing of valve replacement surgery might depend on how likely it is that your valve disease will get worse.
doctor will assess the progression of regurgitation by comparing the results of
your most recent echocardiogram with your earlier results. How often you have an
echocardiogram depends on the severity of your regurgitation. The faster the regurgitation progresses, the sooner you will
need a valve replacement.
If your condition has been progressing slowly, you may be able to
wait a little longer before having a valve replacement. But if you have
other compounding factors, such as high blood pressure and coronary artery
disease, the regurgitation is more likely to get worse soon, and
surgery may be needed sooner.
If you are going to have bypass surgery, your doctor may recommend that you have your valve replaced at the same time.
What are the risks?
The severity of regurgitation and the likelihood it will get worse
need to be balanced against the risks involved with having a valve replacement
surgery has a high rate of success and a low risk of causing other problems if
you are otherwise healthy. But the surgery is an open-heart surgery.
Although most people have successful outcomes, there is a risk of death
and serious problems during surgery. About 5% or less of people having
valve surgery die.1
Even if valve
replacement surgery is a success, you may have problems after surgery, such
An increased risk of blood clots. These can break off and cause a
heart attack. You will need to take blood-thinning
medicines (anticoagulants) right after surgery to help prevent
blood clots. If you get a mechanical valve instead of a tissue valve, you will
need to take blood-thinners for as long as you have that
A need for another replacement valve.
This will depend on the type of valve you get and how long you live after you
have the surgery.
A valve that fails.
There is a small chance that the valve won't work. Your doctor will need to
check from time to time to make sure that your valve is working.