Treatment
| Symptoms | Ejection fraction | Additional Findings |
|---|---|---|
| Present (NYHA II-IV) |
Any | |
| Absent | > 50% | Abnormal exercise test, severe LV dilatation (systolic ventricular diameter >55 mm) |
| Absent | <=50 % | |
| Cardiac surgery for other cause (i.e.: CAD, other valvular disease, ascending aortic aneurysm) | ||
Aortic insufficiency can be treated either medically or surgically, depending on the acuteness of presentation, the symptoms and signs associated with the disease process, and the degree of left ventricular dysfunction.
Surgical treatment is controversial in asymptomatic patients, however has been recommended if the ejection fraction falls to 50% or below, in the face of progressive and severe left ventricular dilatation, or with symptoms or abnormal response to exercise testing. For both groups of patients, surgery before the development of worsening ejection fraction/LV dilatation, is expected to reduce the risk of sudden death, and is associated with lower peri-operative mortality. Also, surgery is optimally performed immediately in acute cases.
Read more about this topic: Aortic Insufficiency
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