Timing of Operation for Chronic Severe Aortic Regurgitation
The indication for aortic valve replacement in chronic severe aortic regurgitation poses different problems. In symptomatic patients the operation offers better results than medical treatment alone, so that in general there are no doubts about surgical indication once a patient develops more than trivial symptoms. Rather, in these cases the problem is of a prognostic nature: which patients will probably have an excellent postoperative recovery and which others might have a worse outcome? Today this is not a very difficult question, since we possess quite accurate predictive criteria based on both invasive and noninvasive evaluation of left ventricular function[1–6]. In asymptomatic (or midly symptomatic) patients, on the contrary the problem is of decisional nature: if and when aortic valve replacement is indicated. This is a more difficult task and will be the main theme of this paper.
KeywordsValve Replacement Left Ventricular Dysfunction Aortic Valve Replacement Aortic Regurgitation Aortic Valve Disease
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