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| {{Aortic insufficiency}}
| | #Redirect [[Aortic regurgitation surgery indications#Indications for Surgery for Acute Aortic Regurgitation]] |
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| {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}, [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S.
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| ==Overview==
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| Severe acute [[aortic insufficiency]] requires emergency surgery if there are no absolute contraindications to surgery.
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| ==Timing of Emergency Surgery==
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| Acute severe aortic insufficiency may cause death due to [[pulmonary edema]], [[ventricular arrhythmias]], [[electromechanical dissociation]], or [[circulatory collapse]]. Individuals with [[bacteremia]] with aortic valve [[endocarditis]] should not wait for treatment with antibiotics to take effect, especially if there is [[hypotension]], [[pulmonary edema]], or low [[cardiac output]] given the high mortality associated with the acute [[aortic insufficiency]].
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| ==Type of Surgery==
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| Replacement with an [[artificial heart valve|aortic valve]] [[homograft]] should be performed if feasible. The surgical approach depends on the cause for aortic insufficiency with valve repair/replacement in cases of valvular structural abnormalities and instead aortic root repair/replacement in cases of [[aortic dissection]].
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| ==Medical Therapy==
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| Patients may be temporarily managed before surgery with [[vasodilators]] such as [[nitroprusside]] and possibly [[inotropic agents]] such as [[dopamine]] or [[dobutamine]] to improve [[stoke volume]] and reduce left ventricular end-diastolic pressure<ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS |title=2008 Focused update incorporated into the ACC/AHA 2006 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 (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Circulation]] |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18820172 |accessdate=2011-04-07}}</ref>. [[Intra-aortic balloon pump]] is '''contraindicated''' as this would worsen aortic regurgitation by increasing after load.
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| ==Mild Acute Aortic Insufficiency in the Setting of Aortic Dissection==
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| In mild aortic insufficiency secondary to [[aortic dissection]], the valve can be repaired/replaced at the time of surgery for aortic dissection.
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| ==[[Aortic insufficiency surgical therapy|Aortic Insufficiency Surgical Procedure]]==
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| ==References==
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| {{reflist|2}}
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| [[Category:Cardiology]]
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| [[Category:Surgery]]
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| [[Category:Cardiac surgery]]
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| [[Category:Template complete]]
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| [[Category:Surgical procedures]]
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| {{WH}}
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| {{WS}}
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