Management includes treating underlying conditions, monitoring asymptomatic patients and identifying indications for aortic valve replacement.
Treatment and indications for surgery
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Underlying conditions, such as endocarditis or syphilis, may require treatment.
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Aortic valve replacement is indicated when aortic regurgitation causes symptoms. Aortic root replacement and coronary bypass surgery may also be needed.
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In asymptomatic patients, aortic valve replacement should be undertaken if the left ventricular end-systolic dimension reaches 50 mm or more, or the left ventricular ejection fraction falls below 50%.
Monitoring chronic aortic regurgitation
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Compensatory ventricular dilatation and hypertrophy can allow patients with chronic aortic regurgitation to remain asymptomatic for many years.
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Patients should report the development of breathlessness or angina.
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Asymptomatic patients should undergo annual echocardiographic follow-up.