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Treatment

Treatment of aortic regurgitation depends on the degree of the regurgitation, your signs and symptoms, and whether the regurgitation is affecting your heart function.

If you have aortic regurgitation, your doctor will evaluate your heart with regular echocardiograms to determine whether damage to your heart is accelerating.

Observation
Some people, especially those with mild regurgitation, need no specific treatment. However, even if you don't have signs and symptoms with aortic regurgitation, schedule regular evaluations with your physician.

Observation isn't the same as ignoring the condition. Actively observing the stability or the progression of the condition is important so that you can receive the right treatment at the right time.

Medications
Currently, no medication can eliminate aortic regurgitation. However, your doctor may prescribe certain medications to improve your heart's overall function.

If you have aortic regurgitation, your doctor may recommend that you take antibiotics before certain dental or medical procedures to prevent the heart infection endocarditis.

Surgery
Once signs and symptoms of aortic regurgitation develop, you'll usually need surgery. However, if aortic regurgitation is weakening your heart, you may need surgery even if you feel well. While the heart is generally adept at counteracting deficiencies caused by a leaky aortic valve, the problem is that if the valve isn't fixed or replaced in time, the strength of your heart may decline so much that it's permanently weakened. You can avoid that by having surgery at the appropriate time.

• Endocarditis

The overall function of your heart and the amount of regurgitation help to determine when surgery is necessary. Surgical procedures include:

• Valve repair. Aortic valve repair is surgery to preserve the valve and to improve its function. Occasionally, surgeons can modify the original valve (valvuloplasty) to eliminate backward blood flow. You don't need long-term anticoagulation therapy after a valvuloplasty.

• Valve replacement. In most cases the aortic valve has to be replaced to correct aortic regurgitation. In valve replacement surgery, the leaky aortic valve is replaced by an artificial (prosthetic) valve. The two types of artificial valves are mechanical and tissue. Mechanical valves are made from metal and are durable, but they carry the risk of blood clots forming on or near the valve. If you have a mechanical valve, you need to use anticoagulant medication for life to prevent blood clots from forming on the valve. Tissue valves generally come from a pig, cow or human cadaver donor heart. These kinds of valves wear out over time, and you may need another operation to replace the valve. However, an advantage of the tissue valve is that you don't have to use long-term anticoagulation medication. Other types of tissue valve replacements include autografts, in which your own pulmonary valve — another heart valve — is used to replace the aortic valve.

Aortic valve surgery usually involves open-heart surgery performed with general anesthesia. Your heart is exposed and connected to a heart-lung machine that assumes your breathing and blood circulation during the procedure. Your surgeon then repairs or replaces your leaky aortic valve. After the operation, which lasts several hours, you spend one or more days in an intensive care unit, where your heart function and general recovery are closely monitored.

Aortic regurgitation can be eliminated with surgery, and you can resume normal activities soon after. The prognosis following surgery is generally very good.

Prevention

Aortic regurgitation largely cannot be prevented.

One possible way to prevent aortic regurgitation is to prevent rheumatic fever. You can do this by making sure you see your doctor when you have a sore throat. Untreated strep throat can develop into rheumatic fever. Fortunately, strep throat is easily treated with antibiotics. Avoiding infections of the blood, including those caused by intravenous drug use, can prevent damage to the aortic valve that leads to aortic regurgitation. In addition, taking good care of your teeth helps prevent bloodstream infections that can damage your heart valves.

• Endocarditis

• fever

• High blood pressure

• Rheumatic fever

• Sore throat

You may be able to prevent aortic regurgitation from worsening by taking good care of your heart and cardiovascular system. Controlling your blood pressure is also important because high blood pressure can lead to aortic valve damage and aortic regurgitation.

To maximize your quality of life if you have aortic regurgitation, your physician may — in addition to other treatments — recommend that you:

• Consume less salt. Cutting back on your salt intake helps you maintain your blood pressure within a normal range, which is important if you have aortic regurgitation.

• Maintain a healthy weight. Keep your weight within a range recommended by your doctor. Extra weight makes extra work for your heart.

• Exercise. Follow an exercise program within guidelines recommended by your doctor. You may have to limit strenuous activity if you have aortic regurgitation. However, doctors usually encourage moderate physical activity.

• See your doctor regularly. Establish a regular evaluation schedule with your cardiologist.

• See your dentist regularly. Receive regular dental care, following recommendations for the prevention of the heart infection endocarditis for any dental procedure.

If you're a woman of childbearing age with aortic regurgitation, discuss pregnancy and family planning with your doctor because your heart works harder during pregnancy. How a heart with aortic regurgitation tolerates this extra work depends on the degree of leakage and how well your heart pumps. Should you become pregnant, you'll need evaluation by your cardiologist and obstetrician throughout your pregnancy, labor and delivery, and after delivery.

• Endocarditis

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