Acute aortic regurgitation surgical treatment: Difference between revisions

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{{SI}}
#Redirect [[Aortic regurgitation surgery indications#Indications for Surgery for Acute Aortic Regurgitation]]
 
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'''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
 
{{Editor Join}
 
The surgical treatment of choice for aortic insufficiency is [[aortic valve replacement]].  This is currently an open-heart procedure, requiring the individual to be placed on [[cardiopulmonary bypass]].
 
==Acute Aortic Insufficiency==
In the case of severe acute aortic insufficiency, all individuals should undergo surgery if there are no absolute contraindications for surgery.  Individuals with bacteremia with aortic valve endocarditis should not wait for treatment with antibiotics to take effect, given the high mortality associated with the acute aortic insufficiency. Instead, replacement with an [[artificial heart valve|aortic valve]] [[homograft]] should be performed if feasible.
 
==Chronic Aortic Insufficiency==
Surgical treatment is controversial in asymptomatic patients. Surgery may be recommended if the [[ejection fraction]] falls below 50% or in the face of progressive and severe left ventricular dilatation.  For both groups of patients, surgery before the development of worse aortic insufficiency [[ejection fracture]]/LV systolic dilatation, is expected to reduce the risk of [[sudden death]], and is associated with lower peri-operative mortality.
 
{| border="1" cellpadding="5" cellspacing="0" align="left"
|+ '''Indications for surgery for chronic severe aortic insufficiency'''<ref>{{cite journal |author= |title=ACC/AHA 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 (Committee on Management of Patients with Valvular Heart Disease) |journal=J. Am. Coll. Cardiol. |volume=32 |issue=5 |pages=1486–588 |year=1998 |pmid=9809971 |doi=}}</ref>
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! style="background:#efefef;" width="150px" | Symptoms
! style="background:#efefef;" width="100px" | Ejection fraction
! style="background:#efefef;" width="150px" | Other information
|-----
| [[New York Heart Association Functional Classification|NYHA class]] III - IV
| ≥ 50 % ||
|-----
| NYHA class II || ≥ 50 %
| Progression of symptoms or worsening parameters on echocardiography
|-----
| CHA class ≥ II [[Angina pectoris|angina]] || ≥ 50 % ||
|-----
| Regardless of symptoms || 25 - 49 % ||
|-----
| colspan="3" | Cardiac surgery for other cause (ie: [[coronary artery disease|CAD]], other valvular disease, ascending aortic aneurysm)
|}
 
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==Severe aortic insufficiency in patient after aortic valve replacement 1==
<googlevideo>-3829359717394053857&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 2==
<googlevideo>-1139143783733805104&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 3==
<googlevideo>-7501177211861270942&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 4==
<googlevideo>-4027195456056520519&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 5==
 
<googlevideo>3983126063629833286&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 6==
 
<googlevideo>5313961274473108141&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 7==
 
<googlevideo>-1049019986268408841&hl=en</googlevideo>
 
==Severe aortic insufficiency in patient after aortic valve replacement 8==
 
<googlevideo>1577454681656420080&hl=en</googlevideo>
 
==References==
{{reflist|2}}
 
[[Category:Cardiology]]
 
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Latest revision as of 15:31, 6 January 2015