Some doctors at the cleveland clinic wrote an article describing when to opt for valve replacement surgury. For the Aortic valve with regurgitation, they say:
Patients with chronic mild-to-moderate
regurgitation and normal left ventricular
function are at low risk and are not candidates
for aortic valve replacement. Appropriate follow-
up consists of an annual history and physical
examination and echocardiography every
2 to 3 years.
However, in other places I see "replace if symptomatic" even if all other parameters are normal.
So, if a patient is having PVCs, some exercise issues (high exercise HR), fatigue, angina, etc., but otherwise has normal LV shape and function (ejection fraction, dimensions, etc), and mild aortic root dialation (3.8cm) should they consider surgery to prevent damage? Or just go in for echos to monitor the heart?
In this case, might the symptoms be unrelated to the aortic regurgitation, and instead indicative of another rhythm disorder that needs to be explored? And are beta-blockers an appropriate medication for such an individual (she has low-normal BP and is 38 years old)
Thanks,
Citation:
JOEL P. REGINELLI, MD
Department of Cardiovascular Medicine,
The Cleveland Clinic Foundation
BRIAN GRIFFIN, MD
Department of Cardiovascular Medicine,
The Cleveland Clinic Foundation
The challenge of valvular heart disease:
When is it time to operate?