Valve Surgery in the Asymptomatic Patient with Aortic Regurgitation: Current Indications and the Effect of Change Rates in Objective Measures

2004 ◽  
pp. 36-47
Author(s):  
J.S. Borer ◽  
PG. Supino ◽  
C. Hochreiter ◽  
E.M. Herrold ◽  
A. Yin ◽  
...  
Keyword(s):  
Aortic Regurgitation ◽  
Asymptomatic Patient ◽  
Valve Surgery ◽  
Objective Measures

scholarly journals 101 Quantifying aortic regurgitation with CMR can predict patients requiring aortic valve surgery

2008 ◽  
Vol 10 (S1) ◽  
Author(s):  
Saul G Myerson ◽  
Theodoros D Karamitsos ◽  
Jane M Francis ◽  
Adrian P Banning ◽  
Stefan Neubauer
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Valve Surgery ◽  
Aortic Valve Surgery

Aortic regurgitation

ESC CardioMed ◽  
2018 ◽  
pp. 1634-1641
Author(s):  
Pilar Tornos Mas ◽  
Emmanuel Lansac
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Surgery ◽  
Valve Surgery ◽  
Aortic Dilatation ◽  
Concomitant Surgery ◽  
Asymptomatic Patients ◽  
Aortic Pathology ◽  
Definition Of ◽  
And Function

Evaluation of aortic regurgitation requires consideration of valve morphology, mechanism and severity of regurgitation and assessment of aortic dilatation. In asymptomatic patients with severe aortic regurgitation, follow-up of symptomatic status and LV size and function is mandatory. The strongest indication for valve surgery is the presence of symptoms and/or the documentation of LVEF <50% and/or end-systolic diameter =50 mm. In patients with dilated aorta, definition of aortic pathology and accurate measurements of aortic diameters are crucial. Surgery is recommended whenever aortic dilation is = 55 mm or = 50 mm in patients with bicuspid aortic valves and Marfan syndrome or =45 mm when additional risk factors are present. For patients who have an indication for valve surgery, an aortic diameter of ≥45 mm is considered to indicate concomitant surgery of the aorta. Aortic valve repair and valve-sparing aortic surgery instead of aortic valve replacement should be considered in selected cases in experienced centres.

scholarly journals Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation

2019 ◽  
Vol 20 (10) ◽  
pp. 1105-1111
Author(s):  
E Mara Vollema ◽  
Gurpreet K Singh ◽  
Edgard A Prihadi ◽  
Madelien V Regeer ◽  
See Hooi Ewe ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Time Course ◽  
Pressure Overload ◽  
Volume Overload ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Lv Mass

Abstract Aims Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR. Methods and results Two hundred and eleven (61 ± 14 years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and/or 5 years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable. Conclusion In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression.

Left ventricular reverse remodeling after aortic valve surgery for acute versus chronic aortic regurgitation

2016 ◽  
Vol 33 (10) ◽  
pp. 1458-1464 ◽  
Author(s):  
Madelien V. Regeer ◽  
Michel I. M. Versteegh ◽  
Nina Ajmone Marsan ◽  
Martin J. Schalij ◽  
Robert J. M. Klautz ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Reverse Remodeling ◽  
Aortic Valve Surgery ◽  
Left Ventricular Reverse Remodeling ◽  
Chronic Aortic Regurgitation
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