What Is the Treatment of Acute Aortic Regurgitation?
Acute aortic regurgitation (acute AR) is a time-critical cardiovascular emergency. The underlying aetiology — which may include infective endocarditis, aortic dissection, or other causes — directly shapes the management pathway and the urgency of intervention.
This protocol addresses the treatment of acute AR, covering the preferred definitive approach as well as temporary haemodynamic measures that may be applied while awaiting intervention.
Treatment approach: Surgical intervention forms the cornerstone of management for acute AR, with the operative strategy guided by the underlying aetiology. Temporary haemodynamic measures may be employed as a bridge — the full sequencing, criteria, and complete algorithm are available in the structured protocol.
References
- Acute severe AR usually requires immediate surgery depending on the aetiology, such as infective endocarditis or spontaneous, traumatic, or iatrogenic aortic dissection.
- Surgery represents the preferred treatment in patients with acute AR, while TAVI has only been described in individual cases or patients with a failed surgical valve (valve-in-valve).
- Fast pacing over a temporary pacemaker lead shortens the diastole and may temporarily improve haemodynamics until the intervention.
DOI: 10.1093/eurheartj/ehaf194
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