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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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Why is surgery done?

Valve 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 life.

Your doctor might recommend valve replacement surgery if you have severe regurgitation and one of the following conditions:1

  • You have symptoms.
  • Your ejection fraction drops below 50% at rest.
  • Your left ventricle enlarges to more than 55 millimeters at rest.
  • You are going to have another open-heart surgery such as bypass surgery.

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.

Your 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.

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