What Is the Treatment of Aortic Regurgitation in Acute Severe Presentation?
Acute severe aortic regurgitation is a time-critical condition. Unlike chronic forms, it develops suddenly — leaving the heart no time to adapt — and typically demands immediate decision-making regardless of the underlying cause.
Clinical scenario
Acute severe AR, where rapid haemodynamic deterioration follows sudden valve incompetence. The aetiology may include infective endocarditis, spontaneous aortic dissection, traumatic aortic dissection, or iatrogenic aortic dissection. Each cause shapes the urgency and nature of intervention, but the common thread is the need for immediate action.
Treatment approach — partial overview
Management in this setting centres on immediate surgical intervention. Until definitive intervention, temporary measures targeting haemodynamic stabilisation may be employed as a bridge.
The complete structured regimen — including the full decision pathway, procedural considerations, and bridging strategies — is available via the link below.
References
DOI: 10.1093/eurheartj/ehaf194
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.
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