Aortic regurgitation
Peer reviewed by Dr Adrian Bonsall, MBBSLast updated by Dr Colin Tidy, MRCGPLast updated 1 Aug 2017
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In this series:Heart valve diseaseMitral stenosisMitral regurgitationAortic stenosisInfective endocarditis
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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.
At a glance
Aortic regurgitation is when blood leaks backward through the aortic valve.
Symptoms may include tiredness, shortness of breath, and swollen ankles.
Mild cases may not need treatment.
Medicines can ease symptoms if heart failure develops.
Surgery to repair or replace the valve may be advised for more severe cases.
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Symptoms
Mild aortic regurgitation may cause no symptoms. However symptoms may include
Shortness of breath, especially with exercise or when you lie down
Swollen ankles (oedema)
Treatment
Back to contentsIf 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.
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What is the outcome?
Back to contentsThe 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.
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Aortic stenosis
The aortic valve is a heart valve that lies between the left ventricle and the aorta. In aortic stenosis, when the aortic valve opens to let blood pump through, it does not open as widely as it would normally. The opening between the left ventricle and the aorta is therefore narrowed (stenosed). The amount of blood that can pass from the left ventricle to the aorta is therefore reduced. The more narrowed the valve, the smaller the amount of blood that can get through, and the more significant the symptoms. In some cases, aortic stenosis occurs at the same time as aortic regurgitation.
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Frequently asked questions
Can aortic regurgitation improve on its own without treatment?
The article implies that if the backflow of blood is mild, treatment might not be necessary, suggesting that it may remain stable or not worsen. However, it does not explicitly state that aortic regurgitation can improve or resolve on its own. It highlights that the outcome is generally poor without treatment if the condition is severe.
What is the typical recovery time after aortic valve surgery?
The article mentions that surgical treatment has greatly improved the outlook for people with severe regurgitation, but it does not provide information on typical recovery times or what to expect in the period immediately following surgery.
Are there any lifestyle changes I can make to help manage aortic regurgitation?
The article focuses primarily on medical and surgical treatments, and the symptoms of the condition. It does not offer specific advice on lifestyle changes that might help manage aortic regurgitation or its symptoms.
How often will I need to be monitored if my aortic regurgitation is mild and doesn't require treatment?
The article states that mild cases may not need treatment, but it does not specify any recommendations for ongoing monitoring or follow-up appointments in such situations.
What are the potential risks associated with mechanical or tissue valve replacement surgery?
The article describes the types of valves used in surgery (mechanical and tissue) and states that surgery has improved outcomes. However, it does not detail the potential risks or complications associated with these surgical procedures or the different types of valves.
Further reading and references
- 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)
- 2023 ESC Guidelines for the management of infective endocarditis; European Society of Cardiology (Aug 2023)
- 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.
- 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 Jun;17(6):421-422. doi: 10.14744/AnatolJCardiol.2017.7925.
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About the authorView full bio
Dr Colin Tidy, MRCGP
General Practitioner, Medical Author
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.
About the reviewerView full bio
Dr Adrian Bonsall, MBBS
Medical Author
MA (Chemistry), MBBS (Hons), DCH
Since 2000 Adrian has been employed in emergency and critical care paediatrics based in Sydney, with particular interests in toxicology, trauma and resuscitation.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
1 Aug 2017 | Latest version
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