Aortic Regurgitation (Aortic Insufficiency)

UT Southwestern Medical Center’s heart experts are leaders in developing new approaches to treating aortic regurgitation, and we have performed more minimally invasive aortic valve replacements than other North Texas centers.

Our doctors offer the experience, skill, and advanced techniques and technologies needed to properly diagnose and treat the valve disorder.

Experienced and Innovative Approaches to Aortic Regurgitation

Aortic regurgitation is a condition in which the aortic valve does not close properly, allowing blood to leak from the aorta back into the heart’s left ventricle.

This leakage increases the left ventricle’s volume load, causing it to dilate and eventually fail – leading to pulmonary (lung) congestion. 

The experienced heart doctors at UT Southwestern have performed more minimally invasive aortic valve replacements than other North Texas centers – and our team is a leader in developing new treatments for valve disorders.

While we offer traditional aortic valve replacement, we strive to perform minimally invasive procedures whenever possible. In most cases, our heart specialists can replace damaged aortic valves without open surgery, which significantly reduces patients’ pain and recovery time.

UT Southwestern also offers a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and can prevent future heart disease.

Causes and Symptoms

Aortic regurgitation can be caused by a number of heart conditions and heart-damaging diseases, such as:

• Aortic dissection: A rare, serious condition that occurs when blood breaks through the inner layer of the aorta and ends up between two layers
  
• Idiopathic aortic root dilatation: A condition typically seen in the elderly and people with high blood pressure or bicuspid aortic valves, a congenital heart condition
  
• Infective endocarditis: A potentially damaging infection of the valve
  
• Lupus: A chronic inflammatory disease that occurs when the body's immune system attacks its own tissues and organs
  
• Marfan syndrome: A genetic disorder of the connective tissue
  
• Rheumatic heart disease: Damaged heart valves and heart failure in patients with a history of rheumatic fever
  
• Syphilis: A potentially life-threatening bacterial infection – typically spread by sexual contact – that can severely damage the heart, brain, and other organs
  

Symptoms of aortic regurgitation include:

• Angina (chest pain)
• Syncope (fainting)
• Heart palpitations, which can be caused by rhythm disorders (cardiac arrhythmias)
• Shortness of breath during exertion, when lying flat, and/or sleeping at night, which can indicate left-sided heart failure

Diagnosis

UT Southwestern doctors will use several tests to determine the problem. Common diagnostic tests for aortic regurgitation include:

• Physical exam: Might include listening with a stethoscope for a diastolic blowing murmur, Corrigan’s pulse, Hill’s sign, pistol-shot femoral pulses, Duroziez’s sign, de Musset’s sign, or Quincke’s pulse
  
• Chest X-ray: Imaging used to check for heart enlargement and aortic dilation
  
• Electrocardiogram (EKG): A test used to evaluate heart rhythm
  
• Echocardiography (echo or cardiac ultrasound): An imaging study used to look for abnormal blood flow across the closed aortic valve
  
• Cardiac catheterization: A minimally invasive procedure used to evaluate the degree of aortic insufficiency and look for aortic stenosis or mitral stenosis
  

Treatment

Patients with aortic regurgitation are treated with medications to alleviate their symptoms until the criteria for aortic valve replacement are met. Patients ineligible for valve replacement are also treated medically to relieve their symptoms.

 Drugs used to treat the symptoms of aortic valve insufficiency include:

• Digitalis compounds: To improve blood flow
  
• Diuretics: To reduce water retention
  
• Vasodilators: To widen the blood vessels
  

Aortic valve replacement is used to treat people with aortic regurgitation who meet the criteria for the procedure. UT Southwestern offers both minimally invasive and traditional valve replacement surgery.

Clinical Trials

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials can receive treatments years before they are available to the public.