Aortic Regurgitation
Before you begin reading about this heart defect, please read the explanation of how the normal heart works for a basic understanding of its structure and function.
- What is aortic regurgitation?
- What are the symptoms?
- How is it diagnosed?
- What are the treatment options?
- What kind of follow-up care is required?
What is aortic regurgitation?
When the heart squeezes, the left ventricle (the lower left chamber) contracts, pushing blood out into the aorta, the main artery that takes blood to the body. The aortic valve sits on the way out of the heart, to prevent blood from leaking back in between beats.
Aortic regurgitation occurs when the valve doesn't completely close and allows some blood to leak back into the heart. This condition is also known as aortic insufficiency. It can be trivial, mild, moderate or severe.
What are the symptoms?
Aortic regurgitation often doesn't cause symptoms in infants or children. As the child gets older, abnormal signs and symptoms may appear, including fatigue, a heart murmur (an extra heart sound when a doctor listens with a stethoscope), or, rarely, chest pain, fainting, or arrhythmias.
How is it diagnosed?
We usually diagnose aortic regurgitation after a primary care doctor detects a heart murmur and refers a child to us. Sometimes aortic regurgitation results from surgery to correct aortic stenosis or other heart defects.
Diagnosis may require some or all of these tests:
- pulse oximetry - a painless way to monitor the oxygen content of the blood
- chest X-ray
- echocardiogram (also called "echo" or cardiac ultrasound) - sound waves create an image of the heart
- electrocardiogram (ECG) - a record of the electrical activity of the heart
- exercise stress test
- cardiac MRI - a three-dimensional image shows the heart's abnormalities
- cardiac catheterization - a thin tube is inserted into the heart through a vein and/or artery in either the leg or through the umbilicus ("belly button")
What are the treatment options?
If the regurgitation is trivial or mild, treatment is usually not necessary. Doctors will monitor the patient with regular checkups, and might even prescribe some medications if the regurgitation is moderate or severe.
Surgery to repair or to replace the valve is often necessary in severe cases. Depending on the age, gender and particular needs of your child, as well as the valve anatomy, surgeons may attempt to repair the valve, or at least improve its function, with a surgery called a valvuloplasty.
Another option includes the use of mechanical (artificial) valves as replacement valves. If this is the case, your child will need to stay on blood-thinning medicines, such as COUMADIN.
Yet another option is the Ross Procedure. In this operation, the aortic valve is replaced with the patient's pulmonary valve. The pulmonary valve is then replaced with one from a donated organ. The valves may grow with the child, and blood-thinners aren't required.
What kind of follow-up care is required?
Through 18
Children with this condition require regular checkups with a pediatric cardiologist.
Our pediatric cardiologists follow patients until they are young adults, coordinating care with the primary care physicians.
Into adulthood
Aortic regurgitation can cause health problems in adults. It is very important that adults with this condition are monitored by a cardiologist regularly. We will help with the transition to an adult cardiologist. All patients with aortic valve disease need lifelong follow-up with a cardiologist.
The Philadelphia Adult Congenital Heart Center, a joint program of The Children's Hospital of Philadelphia and the University of Pennsylvania, meets the unique needs of adults who were born with heart defects.
Because of enormous strides in medicine and technology, today most children with heart conditions go on to lead healthy, productive lives as adults.
Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.
Reviewed by: Jeffrey R. Boris, MD
Date: February 2009
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