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Aortic Regurgitation Treatment & Management

  • Author: Stanley S Wang, MD, JD, MPH; Chief Editor: Richard A Lange, MD, MBA  more...
 
Updated: Feb 12, 2014
 

Approach Considerations

In severe acute aortic regurgitation (AR), surgical intervention is usually indicated, but the patient may be supported medically with dobutamine to augment cardiac output and shorten diastole and with sodium nitroprusside to reduce afterload in hypertensive patients.

Vasodilator therapy may be used on an inpatient or outpatient basis under conditions described in the current ACC/AHA guidelines.[4]

All patients with an artificial heart valve should receive antibiotic prophylaxis prior to dental procedures. For antithrombotic therapy, all patients with an artificial heart valve should receive daily aspirin, and many should also receive oral anticoagulation therapy with warfarin according to the ACC/AHA guidelines.[4]

Although diuretics, nitrates, and digoxin are sometimes used to help control symptoms in patients with AR, not enough data in the clinical literature justify routinely recommending or discouraging these therapies. Also, no data support drug therapy of any class in patients with less than severe AR.[4]

Intra-aortic balloon counterpulsation, which can be used to provide temporary mechanical circulatory support, is contraindicated in patients with severe AR.

Inpatient/outpatient care

Inpatient care is required for most patients with severe acute aortic regurgitation (AR), particularly patients with symptoms or evidence of hemodynamic decompensation. Patients with severe chronic AR may be followed as inpatients or outpatients, depending on the stage of their disease and severity of their symptoms and LV dysfunction.

Transfer

For patients who are hospitalized for severe AR in facilities without appropriate cardiovascular and surgical expertise, transfer may be justified to optimize clinical outcomes. For outpatients with stable but severe AR, longitudinal care by a cardiologist with appropriate expertise is recommended.

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Emergency Department Care

General requirements in emergency department care for patients with AR include the following:

  • Provide adequate airway management
  • Intubate when necessary
  • Consider prompt surgical intervention in acute AR

Acute aortic regurgitation

Administer a positive inotrope (eg, dopamine, dobutamine) and a vasodilator (eg, nitroprusside). Administration of vasodilators may be appropriate to improve systolic function and to decrease afterload.

The administration of cardiac glycosides (eg, digoxin) for rate control may in rare cases be necessary. Avoid beta-blockers in the acute setting.

Chronic aortic regurgitation

Consider antibiotic prophylaxis for patients with endocarditis when performing procedures likely to result in bacteremia. The administration of pressors and/or vasodilators may be appropriate.

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Vasodilator Therapy

In severe chronic AR, vasodilator therapy may be used in select conditions to reduce afterload in patients with systolic hypertension, in order to minimize wall stress and optimize LV function. In normotensive patients, however, vasodilator therapy is not likely to reduce regurgitant volume (preload) significantly and thus may not be of clinical benefit.[32]

The current ACC/AHA guidelines say the following about vasodilator therapy:

  • Vasodilator therapy is indicated for long-term treatment in patients who have severe chronic AR and symptoms of LV dysfunction but who are not candidates for surgery.
  • Vasodilator therapy is reasonable for short-term therapy in patients with severe LV dysfunction and heart failure symptoms, in order to improve their hemodynamic profile before surgery
  • Vasodilator therapy is acceptable for long-term therapy in asymptomatic patients with severe AR and LV dilation with normal EF

Under the current guidelines, vasodilator therapy is not indicated for the following:

  • Long-term therapy in asymptomatic patients with less than severe AR and normal EF
  • Long-term therapy in asymptomatic patients with LV dysfunction who are candidates for surgery
  • Long-term therapy in symptomatic patients with less than severe LV dysfunction who are candidates for surgery

The 2012 European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) guidelines recommend short-term use of vasodilators and inotropic agents to improve the condition of patients with severe heart failure before proceeding with valve surgery. In patients with severe chronic AR and heart failure, vasodilators are useful in the treatment of those who have hypertension, those in whom surgery is contraindicated, or patients whose LV dysfunction persists postoperatively.[33]

Antibiotic Prophylaxis

Under current ACC/AHA guidelines, the prophylactic use of antibiotics prior to dental procedures is no longer routinely recommended for all patients with AR.[4] However, select patient groups for whom prophylactic antibiotic therapy prior to dental procedures may be reasonable include the following:

  • Patients with prosthetic material in their heart - Such as an artificial valve or a valve repaired with prosthetic material
  • Patients with prior infective endocarditis
  • Patients who, following cardiac transplantation, have valve regurgitation due to a structurally abnormal valve
  • Patients with congenital heart disease (CHD) who meet any of the following criteria: (1) Cyanotic CHD that has not been repaired or has been incompletely repaired (including patients with palliative shunts and conduits); (2) repaired CHD using prosthetic material, for the first 6 months postprocedurally (ie, prior to endothelialization of the material); or (3) repaired CHD but the patient is at risk for inhibited endothelialization (ie, with residual defects at or adjacent to the site of the prosthetic material)
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Valve Surgery

Surgical treatment of AR usually requires replacement of the diseased valve with a prosthetic valve, although valve-sparing repair is increasingly possible with advances in surgical technique and technology. Such improvements have also enabled many patients, even those with severe LV dysfunction, to undergo valve surgery instead of cardiac transplantation.[34, 35, 36]

Under current ACC/AHA guidelines, aortic valve surgery is recommended for patients with severe chronic AR under the following circumstances[4] :

  • Patient is symptomatic
  • Patient is asymptomatic, with a resting EF ≤55%
  • Patient is asymptomatic, with LV dilation (LV end-systolic dimension [LVESD] >55 mm)

Surgery is recommended in the ESC/EACTS guidelines for the following patients[33] :

  • Patients with severe AR with symptom onset
  • Patients with LV dysfunction or marked LV dilation, after exclusion of other possible causes
  • Asymptomatic patients with severe AR and impaired LV function (EF < 50%)

Under the ESC/EACTS guidelines, surgery should also be considered if the LV end-diastolic dimension (LVEDD) is >70 mm or the LVESD is >50 mm (or >25 mm/m2 body surface area in patients with small body size).

Additional circumstances in which aortic valve surgery may be reasonable include the following:

  • Patient has moderate AR and is undergoing coronary artery bypass surgery or other surgery involving the ascending aorta
  • Patient has severe AR with no symptoms, normal EF, and less severe LV dilation (LVESD >50 mm or LVEDD >70 mm), if the patient experiences (1) progressive LV dilation on serial imaging studies, (2) deteriorating exercise tolerance, or (3) abnormal hemodynamic responses to exercise, such as an inability to augment blood pressure during a treadmill study

In patients undergoing aortic valve surgery for bicuspid aortic valve disease who also have a dilated or aneurysmal ascending aorta with a diameter of more than 4.5 cm, concurrent aortic root repair or replacement is indicated.

Aortic valve surgery is generally not indicated in asymptomatic patients with normal EF and less LV dilation (LVESD < 50 mm or LVEDD < 70 mm).

Mechanical versus bioprosthetic aortic valves

For patients undergoing aortic valve replacement, careful consideration should be given to the relative risks and benefits of mechanical versus bioprosthetic valves.

Traditionally, mechanical valves have been thought to be more durable, but they require long-term anticoagulation therapy with warfarin due to an increased risk of thrombosis. The use of bioprosthetic valves avoids the need for long-term warfarin, but they carry a greater risk of long-term deterioration and a need for reoperation.[37]

In some cases, the choice of valve is apparent; eg, a homograft is often preferred to a mechanical valve in the setting of active infective endocarditis.

While further discussion is beyond the scope of this article, the reader is referred to the current ACC/AHA guidelines, which include major criteria for aortic valve selection, as well as recommendations for antithrombotic therapy (including aspirin for all prosthetic valve recipients along with long-term anticoagulation with warfarin for selected patients).[4]

Transcatheter aortic valve replacement as a treatment

Transcatheter aortic valve replacement (TAVR) has emerged as an important therapy for aortic stenosis (with or without AR) and now is being evaluated for use in patients with predominantly AR. TAVR involves the implantation of a bioprosthetic aortic valve using a catheter that is inserted peripherally, typically through the femoral artery, and implanted without requiring a median sternotomy (ie, without “open heart surgery”). Initial reports are promising but further studies are needed before TAVR becomes clinically available.[38]

TAVR as a cause

Management of AR that is the result of TAVR, typically following its use for aortic stenosis, depends on the severity and hemodynamic impact of the AR. Once a determination is made that the patient is likely to benefit from intervention, potential corrective measures (each of which carries unique risks include the following:[8]

  • Balloon postdilation - In cases of valve malapposition or underexpansion
  • Snare technique - Use of a snare catheter to reposition a deeply implanted valve
  • Interventional closure - Use of a vascular plug to seal a localized AR jet
  • Valve-in-valve implantation - Deployment of a second prosthetic valve
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Diet and Activity

No specific dietary recommendations exist pertaining purely to AR. However, for patients with hypertension or hypervolemia (including peripheral edema or other heart failure symptoms), salt restriction may provide significant clinical benefit.

Current recommendations regarding activity in patients with AR are based mostly on expert opinion, because there is a paucity of clinical trial data, including no convincing evidence to suggest that even strenuous periodic exercise worsens LV function in patients with AR.

Patients who are asymptomatic and have a normal EF may safely participate in normal daily activities as well as mild exercise and some forms of competitive exercise. However, isometric exercise is discouraged. The short-term safety of more vigorous exercise (eg, competitive athletics) may be estimated through the use of stress testing at a comparable level of exertion, but the long-term effects of such exercise are not known.

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Long-Term Monitoring

Asymptomatic patients with severe chronic AR require ongoing clinical surveillance with periodic echocardiography. This is because significant LV dysfunction in many cases may arise even before the patient becomes symptomatic.

After the initial study, clinical evaluation and a repeat echocardiogram are recommended in 3 months. The recommended frequency of subsequent follow-up evaluations is based on the stability of the LVESD and LVEDD, as follows:

  • For patients with an end-systolic dimension (ESD) below 45 mm or an end-diastolic dimension (EDD) below 60 mm and stable dimensions, clinical evaluation is recommended every 6-12 months and repeat echocardiography is recommended every 12 months
  • For patients with an ESD below 45 mm or an EDD below 60 mm and increasing dimensions, clinical evaluation and repeat echocardiography are recommended in 3 months
  • For patients with an ESD of 45-50 mm or an EDD of 60-70 mm and stable dimensions, clinical evaluation is recommended every 6 months and repeat echocardiography is recommended every 12 months
  • For patients with an ESD of 45-50 mm or an EDD of 60-70 mm and increasing dimensions, clinical evaluation and repeat echocardiography are recommended in 3 months
  • For patients with an ESD of 50-55 mm or an EDD of 70-75 mm and stable dimensions, clinical evaluation and repeat echocardiography are recommended every 6 months
  • For patients with an ESD of 50-55 mm or an EDD of 70-75 mm and increasing dimensions, clinical evaluation and repeat echocardiography are recommended in 3 months
  • For patients with an ESD below 55 mm or an EDD below 75 mm, surgery is recommended
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Contributor Information and Disclosures
Author

Stanley S Wang, MD, JD, MPH Clinical Cardiologist, Austin Heart South; Director of Legislative Affairs, Austin Heart; Director, Sleep Disorders Center at Heart Hospital of Austin; Assistant Professor of Medicine (Adjunct), University of North Carolina School of Medicine

Stanley S Wang, MD, JD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, American Society of Echocardiography, Texas Medical Association, American Academy of Sleep Medicine, American Stroke Association, American Society of Nuclear Cardiology

Disclosure: Nothing to disclose.

Chief Editor

Richard A Lange, MD, MBA President, Texas Tech University Health Sciences Center, Dean, Paul L Foster School of Medicine

Richard A Lange, MD, MBA is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American Heart Association, Association of Subspecialty Professors

Disclosure: Nothing to disclose.

Acknowledgements

Eric C Appelbaum, DO Associate Medical Director, Ambulatory Care, Associate Director, Emergency Department, St Barnabas Hospital, Bronx

Eric C Appelbaum, DO, is a member of the following medical societies: American College of Osteopathic Emergency Physicians, American College of Osteopathic Internists, and American Osteopathic Association

Disclosure: Nothing to disclose.

Jerry Balentine, DO Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St Barnabas Hospital

Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine

Disclosure: Nothing to disclose.

David FM Brown, MD Associate Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital

David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Steven J Compton, MD, FACC, FACP, FHRS Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals

Steven J Compton, MD, FACC, FACP, FHRS is a member of the following medical societies: Alaska State Medical Association, American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, and Heart Rhythm Society

Disclosure: Nothing to disclose.

Elizabeth Kassapidis, DO Resident Physician, Department of Emergency Medicine, New York College of Osteopathic Medicine and Saint Barnabas Hospital

Disclosure: Nothing to disclose.

Martin Gerard Keane, MD, FACC, FAHA Associate Professor, Cardiovascular Medicine Division, Department of Medicine, University of Pennsylvania School of Medicine

Martin Gerard Keane, MD, FACC, FAHA is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Heart Association, American Society of Echocardiography, Pennsylvania Medical Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Gary Setnik, MD Chair, Department of Emergency Medicine, Mount Auburn Hospital; Assistant Professor, Division of Emergency Medicine, Harvard Medical School

Gary Setnik, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: SironaHealth Salary Management position; South Middlesex EMS Consortium Salary Management position; ProceduresConsult.com Royalty Other

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Suzanne White, MD Medical Director, Regional Poison Control Center at Children's Hospital, Program Director of Medical Toxicology, Associate Professor, Departments of Emergency Medicine and Pediatrics, Wayne State University School of Medicine

Suzanne White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Clinical Toxicology, American College of Epidemiology, American College of Medical Toxicology, American Medical Association, and Michigan State Medical Society

Disclosure: Nothing to disclose.

References
  1. Roberts WC, Vowels TJ, Ko JM. Natural history of adults with congenitally malformed aortic valves (unicuspid or bicuspid). Medicine (Baltimore). 2012 Nov. 91(6):287-308. [Medline].

  2. Saura D, Peñafiel P, Martínez J, de la Morena G, García-Alberola A, Soria F, et al. [The frequency of systolic aortic regurgitation and its relationship to heart failure in a consecutive series of patients]. Rev Esp Cardiol. 2008 Jul. 61(7):771-4. [Medline].

  3. Braunwald E. Heart Disease: A Textbook of Cardiovascular Medicine. 3rd ed. Philadelphia, Pa: Saunders; 1988.

  4. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD. 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. J Am Coll Cardiol. 2008 Sep 23. 52(13):e1-142. [Medline]. [Full Text].

  5. Babu AN, Kymes SM, Carpenter Fryer SM. Eponyms and the diagnosis of aortic regurgitation: what says the evidence?. Ann Intern Med. 2003 May 6. 138(9):736-42. [Medline].

  6. Giuliani E. Cardiology: Fundamentals and Practice. 2nd ed. Philadelphia, Pa: Mosby Year Book; 1991.

  7. Kloner R. The Guide to Cardiology. 2nd ed. New York: Le Jacq Communications; 1990.

  8. Sinning JM, Vasa-Nicotera M, Chin D, Hammerstingl C, Ghanem A, Bence J, et al. Evaluation and management of paravalvular aortic regurgitation after transcatheter aortic valve replacement. J Am Coll Cardiol. 2013 Jul 2. 62(1):11-20. [Medline].

  9. Aggarwal A, Raghuvir R, Eryazici P, Macaluso G, Sharma P, Blair C, et al. The development of aortic insufficiency in continuous-flow left ventricular assist device-supported patients. Ann Thorac Surg. 2013 Feb. 95(2):493-8. [Medline].

  10. Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. 2008 Feb. 6(2):235-48. [Medline].

  11. Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. 2008 May-Jun. 26(3 Suppl 49):S131-4. [Medline].

  12. Schirmer M, Weidinger F, Sandhofer A, Gschwendtner A, Wiedermann C. Valvular disease and myocardial infarctions in a patient with Behçet disease. J Clin Rheumatol. 2003 Oct. 9(5):316-20. [Medline].

  13. Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Cardiol Rev. 2007 Mar-Apr. 15(2):55-61. [Medline].

  14. Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. 1999 Nov-Dec. 8(6):333-8. [Medline].

  15. Jain D, Halushka MK. Cardiac pathology of systemic lupus erythematosus. J Clin Pathol. 2009 Jul. 62(7):584-92. [Medline].

  16. Moyssakis I, Tektonidou MG, Vasilliou VA, Samarkos M, Votteas V, Moutsopoulos HM. Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution. Am J Med. 2007 Jul. 120(7):636-42. [Medline].

  17. Lee JL, Naguwa SM, Cheema GS, Gershwin ME. Revisiting Libman-Sacks endocarditis: a historical review and update. Clin Rev Allergy Immunol. 2009 Jun. 36(2-3):126-30. [Medline].

  18. Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg. 2007 Dec. 84(6):1950-3. [Medline].

  19. Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. 1997 Jun 1. 126(11):920. [Medline].

  20. Maurer G. Aortic regurgitation. Heart. 2006 Jul. 92(7):994-1000. [Medline].

  21. Singh JP, Evans JC, Levy D, et al. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol. 1999 Mar 15. 83(6):897-902. [Medline].

  22. Feldman T. Rheumatic heart disease. Curr Opin Cardiol. 1996 Mar. 11(2):126-30. [Medline].

  23. Keane MG, Pyeritz RE. Medical management of Marfan syndrome. Circulation. 2008 May 27. 117(21):2802-13. [Medline]. [Full Text].

  24. Ortiz JT, Shin DD, Rajamannan NM. Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm. Curr Treat Options Cardiovasc Med. 2006 Dec. 8(6):461-7. [Medline].

  25. Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ. Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study. Circulation. 1999 Apr 13. 99(14):1851-7. [Medline].

  26. Atalar E, Yorgun H, Canpolat U, Sunman H, Kepez A, Kocabas U, et al. Prevalence of coronary artery disease before valvular surgery in patients with rheumatic valvular disease. Coron Artery Dis. 2012 Dec. 23(8):533-7. [Medline].

  27. Lancellotti P, Tribouilloy C, Hagendorff A, Moura L, Popescu BA, Agricola E, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). Eur J Echocardiogr. 2010 Apr. 11(3):223-44. [Medline].

  28. Picano E, Pibarot P, Lancellotti P, Monin JL, Bonow RO. The emerging role of exercise testing and stress echocardiography in valvular heart disease. J Am Coll Cardiol. 2009 Dec 8. 54(24):2251-60. [Medline].

  29. Gaztanaga J, Pizarro G, Sanz J. Evaluation of cardiac valves using multidetector CT. Cardiol Clin. 2009 Nov. 27(4):633-44. [Medline].

  30. Morello A, Gelfand EV. Cardiovascular magnetic resonance imaging for valvular heart disease. Curr Heart Fail Rep. 2009 Sep. 6(3):160-6. [Medline].

  31. Myerson SG. Valvular and hemodynamic assessment with CMR. Heart Fail Clin. 2009 Jul. 5(3):389-400, vi-vii. [Medline].

  32. Bekeredjian R, Grayburn PA. Valvular heart disease: aortic regurgitation. Circulation. 2005 Jul 5. 112(1):125-34. [Medline].

  33. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2012 Oct. 33(19):2451-96. [Medline].

  34. Bhudia SK, McCarthy PM, Kumpati GS, Helou J, Hoercher KJ, Rajeswaran J, et al. Improved outcomes after aortic valve surgery for chronic aortic regurgitation with severe left ventricular dysfunction. J Am Coll Cardiol. 2007 Apr 3. 49(13):1465-71. [Medline].

  35. Sambola A, Tornos P, Ferreira-Gonzalez I, Evangelista A. Prognostic value of preoperative indexed end-systolic left ventricle diameter in the outcome after surgery in patients with chronic aortic regurgitation. Am Heart J. 2008 Jun. 155(6):1114-20. [Medline].

  36. Christ T, Grubitzsch H, Claus B, Konertz W. Long-term follow-up after aortic valve replacement with Edwards Prima Plus stentless bioprostheses in patients younger than 60 years of age. J Thorac Cardiovasc Surg. 2012 Nov 14. [Medline].

  37. Rahimtoola SH. Choice of prosthetic heart valve in adults an update. J Am Coll Cardiol. 2010 Jun 1. 55(22):2413-26. [Medline].

  38. Yeow WL, Roberts-Thomson P, Shetty S, Yong G. Expanding Role for Transcatheter Aortic Valve Replacement: Successful Transfemoral Implantation of a Medtronic CoreValve for Severe Aortic Regurgitation. Heart Lung Circ. 2012 Nov. 21(11):754-8. [Medline].

  39. Sampat U, Varadarajan P, Turk R, Kamath A, Khandhar S, Pai RG. Effect of beta-blocker therapy on survival in patients with severe aortic regurgitation results from a cohort of 756 patients. J Am Coll Cardiol. 2009 Jul 28. 54(5):452-7. [Medline].

  40. Aggarwal A, Raghuvir R, Eryazici P, Macaluso G, Sharma P, Blair C, et al. The development of aortic insufficiency in continuous-flow left ventricular assist device-supported patients. Ann Thorac Surg. 2013 Feb. 95(2):493-8. [Medline].

 
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Aortic regurgitation. Color Doppler echocardiogram.
Aortic regurgitation. Doppler echocardiographic signals may be reviewed to evaluate the severity of disease.
Aortic regurgitation. Two-dimensional (2D) color Doppler echocardiography.
Aortic regurgitation. Aortic-root angiography shows regurgitation of contrast material into the left ventricle (LV).
Aortic regurgitation. Chest radiograph in a patient with aortic dissection and acute aortic regurgitation shows a cardiac silhouette of essentially normal dimension.
 
 
 
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