Treatment of Symptomatic Chronic Severe Aortic Regurgitation

This protocol addresses symptomatic chronic severe aortic regurgitation — a clinical setting in which the combination of symptom burden and the severity of regurgitation drives the need for definitive intervention.

Clinical scenario

In patients with severe aortic regurgitation who become symptomatic, aortic valve surgery is the standard recommended approach. Where the anticipated surgical risk is considered prohibitive, or the patient is not a surgical candidate, an alternative interventional pathway guided by the Heart Team is indicated.

Treatment approach

For selected patients in this scenario, a transcatheter valve approach at an experienced centre may be considered — subject to Heart Team assessment of anatomical suitability. The complete criteria and structured regimen are available below.

References

DOI: 10.1093/eurheartj/ehaf194

  • AV surgery is recommended in symptomatic patients with severe AR regardless of LV function.
  • When the patient is symptomatic and AR severe, surgery is recommended unless the anticipated surgical risk is prohibitive.
  • TAVI may be considered for the treatment of severe AR in symptomatic patients ineligible for surgery according to the Heart Team, if the anatomy is suitable.
  • TAVI may be considered at experienced centres for selected patients with AR who are ineligible for surgery.
View source ↗