Jason Park, BSc
Chronic aortic regurgitation is common in the elderly. Indeed, a Finnish study looking at the prevalence of aortic valve abnormalities found that 13% of a random, asymptomatic elderly population had moderate to severe evidence of aortic regurgitation when imaged with echocardiography.1 Although chronic aortic regurgitation is usually insidious in its course, it can progress to cause permanent myocardial damage and congestive heart failure. Major indications for surgical correction of severe chronic aortic regurgitation are the onset of more than mild symptoms, such as dyspnea, or echocardiographic evidence of left ventricular systolic dysfunction. Surgery should be performed before systolic dysfunction is significant in order to limit progression of the disease and possible irreversible myocardial dysfunction. Careful follow-up of patients with chronic aortic regurgitation is required, including a detailed history, physical examination, and echocardiography, in order to optimize the benefits of surgery and limit the possibility of permanent myocardial damage.
Etiology and Pathophysiology
Chronic aortic regurgitation results from incomplete closure of the aortic valve due to disease of either the aortic root or the aortic valve itself. A frequent cause of aortic regurgitation is idiopathic aortic root dilatation, which is associated with hypertension.
