Common difficulties in treating aortic valve regurgitation
Treatment for aortic valve regurgitation usually depends on whether you have symptoms from your leaky heart valve and whether your heart is pumping effectively. Common difficulties in treating aortic valve regurgitation arise from:
- Failure to report symptoms. It is extremely important that you report any symptoms or changes in your symptoms to your doctor. Even if an issue seems insignificant to you, you should mention it so that your doctor can assess it in light of your regurgitation and overall health. Without your help, your doctor may miss important signs that signal critical changes in your condition.
- Failure to replace valve before permanent damage occurs. It is important that you have the valve replaced before it causes permanent damage to your heart. This can mean having valve replacement surgery before you develop any symptoms of regurgitation. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend you have your aortic valve replaced if you have severe regurgitation and you have symptoms, your ejection fraction drops below 50% at rest, your left ventricle enlarges (dilates) to more than 55 mm at rest, or you are going to have another open-heart surgery such as coronary artery bypass graft surgery.1 Your doctor may recommend that you have surgery even if you do not have symptoms because symptoms typically only occur after the condition has progressed to the point that it has already damaged the heart.
- Failure to treat multivalvular problems during surgery. It is important to treat any valve problems you have with one surgery. Treating one valve problem and leaving another will not alleviate all of the stress placed on your heart. This means the damage that is being done to your heart will continue and can have a serious negative effect on your chances for survival immediately after surgery. Over a period of many years, your heart has adjusted to the combination of valve problems you have and has compensated. When you fix one valve and not another, your heart does not have time to develop compensations—this can create new problems that may be even harder on your heart than multiple valve problems.
- Failure to treat other conditions simultaneously. Valve problems often occur in conjunction with other diseases of your circulatory system, such as coronary artery disease (CAD). It is important that your treatment be tailored to address both of these conditions, or any others you may have. Each condition on its own can cause heart failure, and having both even further increases the chances you will develop heart failure. It is important that you attempt to control both factors rather than just one.
- Ineffective or insufficient monitoring of the condition. Once you have been diagnosed with aortic valve regurgitation, it is important that your condition be monitored periodically for changes. This monitoring should use a test, such as an echocardiogram, that allows your doctor to assess valve function and not just your ejection fraction. Your heart has an amazing ability to compensate for regurgitation and maintain normal ejection fractions even when your valve is malfunctioning. Not monitoring regularly enough can lead to insufficient monitoring, which can cause two problems. First, it may be difficult to measure changes in your condition if you do not have a recent reading with which to compare it. Second, insufficient monitoring could allow your condition to develop to a critical point before it is noticed.
| Author: | Robin Parks, MS | Last Updated: January 24, 2008 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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