{"id":5332,"date":"2025-03-27T16:48:33","date_gmt":"2025-03-27T16:48:33","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=5332"},"modified":"2025-04-23T13:25:20","modified_gmt":"2025-04-23T13:25:20","slug":"aortic-regurgitation","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/aortic-regurgitation\/","title":{"rendered":"Aortic Regurgitation: What Should Patients Know?"},"content":{"rendered":"<p>When a patient receives a diagnosis of aortic valve regurgitation, the saying, \u201cKnowledge is Power,\u201d takes on a whole new meaning. The patients in our community with <a href=\"https:\/\/www.heart-valve-surgery.com\/aortic-valve-regurgitation-symptoms.php\">aortic valve regurgitation, a leaky valve,<\/a> are at many different stages of their journey. Some patients have been living with aortic valve regurgitation for many years and are in the \u201cwatchful waiting\u201d phase, which means their physician closely monitors with regular echocardiograms as they may need surgery in the future.<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5338 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/aortic-valve-drawing.jpg\" alt=\"Drawing of the Aortic Valve inside the Aorta\" width=\"650\" height=\"363\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>Other patients may have just been diagnosed with the valvular defect, also known as aortic insufficiency, and are beginning to navigate the vast amount of information available. Some patients already have their surgery scheduled and are counting down the days to their operation. It doesn\u2019t matter where one is on the journey of aortic valve regurgitation, a key priority becomes learning more and understanding the options to fix the problem and return to normal life activities.<\/p>\n<p>I wanted to provide our community with a current and comprehensive understanding of aortic regurgitation and its treatments. That\u2019s why I recently met with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Pedro-Catarino-Los+Angeles-California.php\">Dr. Pedro Catarino<\/a>, Director of Aortic Surgery at Cedars-Sinai in Los Angeles. With his extensive experience in cardiac surgery and his sub-specialty in aortic valve repair, Dr. Catarino is uniquely positioned to share his invaluable insights and expertise about aortic valve regurgitation.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/5DVNHxhsYvk?rel=0?si=JASDnxPDFz-RfA1U\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About Aortic Regurgitation<\/h2>\n<p>Here are key insights shared by Dr. Catarino:<\/p>\n<ul>\n<li>Learn the important facts about the aortic valve.<strong> \u201c<\/strong>Aortic regurgitation is a fancy way of saying that you have a leaky aortic valve,\u201d said Dr. Catarino. \u201cThe aortic valve is the valve between the heart&#8217;s main pumping chamber and your aorta. The aorta is the blood vessel that takes blood all over your body. When the aortic valve closes, it\u2019s responsible for the lower number of your blood pressure. So, you may check your blood pressure at home. You get the top number, which is when the heart beats forward, and then you get the bottom number when the heart relaxes.\u201d\u00a0 Catarino explained that the heart doesn\u2019t relax down to zero because the aortic valve keeps that blood pressure up. The textbook number for the lower blood pressure is 80, but the number would be much lower if the aortic valve wasn\u2019t there.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Understand the common structural problems with the aortic valve. Dr. Catarino stated, &#8220;The aortic valve is a semi-lunar valve, meaning it is a half-moon shape. There are three of these half-moons, and they are close against each other, and when the leaflets press together, the valve is competent. When they don\u2019t press together, you get a leak or aortic regurgitation. The causes of aortic regurgitation are anything that disrupts that closure of the half-moon valves, and that problem could be with the leaflets themselves. Perhaps one of the most common reasons is patients born with two leaflets slightly fused. We call that a bicuspid valve, which can lead to a leaky valve. Also, if the ring of the valve, which we call the annulus, is pulled slightly apart, those half-moons won\u2019t quite close centrally, and you can get a leak. Also, anything that destroys the leaflets, such as an infection, could also cause aortic regurgitation.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-5340 size-full aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/aortic-annulus-drawing.jpg\" alt=\"Drawing of Aortic Annulus\" width=\"650\" height=\"362\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>What are the symptoms of aortic regurgitation? \u201cA Leaky valve results in the heart having to do more work because each time it beats it expels all the blood, but with aortic regurgitation, some of that blood comes back, and the heart has to do extra work,\u201d said Dr. Catarino. \u201cThe heart can compensate to a certain extent for the leak by dilating a bit.\u201d He explained that it works harder when the heart is more dilated. An echocardiogram will show that the left ventricle ejection fraction will increase, which shows the heart is working extra hard. \u201cThere comes a point when the heart reaches the limit of its compensation and then you start to get symptoms like shortness of breath on exertion or perhaps even chest pain as the pressure in the heart goes up,\u201d said Dr. Catarino. \u201cSometimes the stretch of the heart can cause arrhythmias, which is when your heartbeat can be either very fast or irregular.\u201d Dr. Catarino also said that if you\u2019ve had aortic regurgitation for a while, it may even cause damming of the blood behind the valve which in turn causes fluid retention. Some symptoms of fluid retention include swelling in the ankles or other places like the stomach.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>What are the risks to a patient\u2019s health from aortic regurgitation? Dr. Catarino stated, \u201cWell, initially I said that the heart can compensate for the aortic regurgitation, but there comes a point when the heart muscle gets bigger, begins to scar up, and will get fibrosis. Once that starts to develop the chance to recover that muscle by having the valve repaired or replaced is diminished and it starts a patient down a path towards heart failure, which is the eventual result of untreated aortic regurgitation.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>What are the treatment options for aortic regurgitation to prevent heart failure? \u201cAortic regurgitation is a mechanical problem, so it really needs a mechanical solution, which means surgery,\u201d said Dr. Catarino. \u201cThere are two broad surgical options, and I\u2019ll go through the standard option first, which is a replacement of the valve. It\u2019s very widely practiced, and there have been hundreds of thousands of aortic valve replacements.\u201d Dr. Catarino said there are two options for valve replacement: a mechanical valve or a tissue valve.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5342 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/heart-valve-replacement-mechanical-tissue.jpg\" alt=\"Heart Valve Replacement Options Mechanical &amp; Tissue\" width=\"650\" height=\"362\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>The mechanical valve replacement.<strong> \u201c<\/strong>First, there is a mechanical valve made of carbon fiber that is extremely durable. It will last a lifetime, even in a young person.\u201d Dr. Catarino explained that mechanical valve replacement requires a patient to take blood-thinning medications to prevent a blood clot from forming on the valve, which could cause a stroke or a valve malfunction. The effects of the blood-thinning medication can vary for each patient, and regular blood tests can impede some people\u2019s lifestyles.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>The tissue valve replacement. \u201cThe alternative to a mechanical valve is a tissue valve,\u201d said Dr. Catarino. \u201cNow we mostly use cow tissue valves. They\u2019re not cow valves but valves made with the lining of a cow\u2019s heart, which makes a reproducible material that can be made in a factory into a three-leaflet valve that looks much like our native valves. It comes on a strut, which is what the surgeon sews into place to do the replacement.\u201d He explained that the advantage of a tissue valve is that it is friendly to the bloodstream and doesn\u2019t require blood thinners. However, since it is a natural tissue, it suffers a lot of wear and tear similar to a native valve, so its durability is limited compared to the mechanical valve. \u201cI typically tell patients that it will last about 15 years, at which point it would need some other intervention. It could be repeat surgery, or it could be a transcatheter valve replacement.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Aortic valve repair may be another option.<strong> \u201c<\/strong>Earlier I mentioned one of the ways in which the valve could leak is if the semi-lunar leaflets are not opposing because they\u2019ve been pulled apart by a stretched ring,\u201d said Dr. Catarino. \u201cThe surgeon can tighten that ring, bringing the leaflets back together so they oppose and don\u2019t leak. I also said that a big cause was the fusion of two leaflets, which disrupts how they come together. There are some surgical techniques to lift up the valve, stop it from prolapsing, and get opposition back. With those specialized techniques, we\u2019re able to preserve the native valve and that\u2019s a good thing because it\u2019s the most durable and not susceptible to infection because there isn\u2019t a foreign body in the bloodstream.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Other forms of aortic replacement or reconstruction.<strong> \u201c<\/strong>Yes, of course, there is also the <a href=\"https:\/\/www.heart-valve-surgery.com\/ross-procedure-aortic-disease\">Ross Procedure<\/a>, which is another way of keeping your own native valve. Two valves in the heart have these semi-lunar leaflets, the aortic valve and the pulmonary valve.\u201d Dr. Catarino explained that since the pulmonary valve has the exact structure of the aortic valve, they can take the pulmonary valve out of its location, put it into the aortic position, and put a donor valve into the pulmonary position. \u201cThe advantage is that the pressures in the pulmonary circulation are much lower, so the donor valve in the pulmonary position will be more durable. The Ross procedure is mostly done for patients with aortic stenosis, a narrowed aortic valve.\u201d Dr Catarino also said they have a technique at Cedars called the Supported Ross Procedure. \u201cIn the context of aortic regurgitation, the pulmonary valve, used to much lower pressures, tends to dilate and stretch over time. With the Supported Ross, we put the pulmonary valve inside another conduit made of special medical grade polyester that goes around the outside of the pulmonary valve and allows it to maintain its structure in the systemic circulation with a higher pressure.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5343 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/supported-ross-prcedure.jpg\" alt=\"Supported Ross Procedure\" width=\"650\" height=\"361\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>What is the life expectancy after a procedure to fix aortic valve regurgitation?<strong> \u201c<\/strong>So, I have excellent news for you. We can bring patients\u2019 life expectancy back up to the normal expected for their age with any of these procedures, whether it\u2019s repair, repair with aneurysm correction, or replacement.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Thanks Dr. Catarino and Cedars-Sinai!<\/h2>\n<p>On behalf of all the patients at HeartValveSurgery.com, and patients all over the world, thanks so much to Dr. Pedro Catarino for the work that you and your team are doing at Cedars-Sinai to help patients with aortic regurgitation.<\/p>\n<p>Related Links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Pedro-Catarino-Los+Angeles-California.php\">See Dr. Pedro Catarino&#8217;s Interactive Surgeon Profile<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/ross-procedure-aortic-disease\">Discover the New Ross Procedure Patient Education Center<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard-of-hearing members of our patient community, we have provided a written transcript of our interview with Dr. Catarino below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"class_list":["post-5332","page","type-page","status-publish","hentry","category-before-surgery"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5332","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=5332"}],"version-history":[{"count":17,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5332\/revisions"}],"predecessor-version":[{"id":5526,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5332\/revisions\/5526"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=5332"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=5332"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}