Aortic Regurgitation
Aortic regurgitation is sometimes called aortic incompetence or a leaky aortic valve. In aortic regurgitation the valve does not close properly. The aortic valve is a heart valve that lies between the left ventricle and the aorta. Therefore, blood leaks back (regurgitates) into the left ventricle from the aorta.
In some cases, aortic regurgitation occurs at the same time as aortic stenosis. Read more about aortic stenosis.
Symptoms
Mild aortic regurgitation may cause no symptoms. However symptoms may include
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- Tiredness
- Weakness
- Shortness of breath, especially with exercise or when you lie down
- Lightheadedness or fainting
- Swollen ankles (oedema)
Treatment
If the backflow of blood is mild then you may not need any treatment. If you develop complications, various medicines may be advised. Surgery may sometimes be advised.
Medication
Medication may be advised to help ease symptoms of heart failure if heart failure develops - for example, angiotensin-converting enzyme (ACE) inhibitors and/or 'water' tablets (diuretics). See separate leaflet called Heart Failure for more details on treatment methods.
Surgery
Surgical options include repair of the aortic valve or replacement of the valve. The most recent guideline recommends replacement as the preferred option in most cases.
Valve replacement surgery may be with a mechanical or a tissue valve. Mechanical valves are made of materials which are not likely to react with your body, such as titanium. Tissue valves are made from treated animal tissue, such as valves from a pig. If you need surgery, a surgeon will advise on which is the best option for your situation.
Surgical treatment has greatly improved the outlook in most people with more severe regurgitation. The outlook (prognosis) is good if the valve is treated before the heart becomes badly damaged.
What is the outcome?
The outcome (prognosis) will depend on the underlying cause and the severity of aortic regurgitation. The outcome is generally poor if there is no treatment but is good with available modern treatments.
Further reading and references
Nishimura RA, Otto CM, Bonow RO, et al; 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. Circulation. 2017 CIR.0000000000000503. Originally published March 15, 2017.
2015 ESC Guidelines for the management of infective endocarditis; European Society of Cardiology (Aug 2015)
Prophylaxis against infective endocarditis: Antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures; NICE Clinical Guideline (March 2008 - last updated July 2016)
Vahanian A et al; Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology, 2017.
Ozkan M; What is new in ACC/AHA 2017 focused update of valvular heart disease guidelines. Anatol J Cardiol. 2017 Jun17(6):421-422. doi: 10.14744/AnatolJCardiol.2017.7925.
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