Aortic regurgitation

Abstract

Aortic regurgitation (AR) is one of the most frequently encountered heart valve diseases, following aortic valve stenosis and mitral valve regurgitation. In the last decade, repair techniques for diseased heart valves have received increasing attention, with the perception that maintaining the normal architecture of the valve apparatus would be beneficial to the patients. Thanks to innovations in operative techniques, an improved understanding of the functional anatomy of the aortic valve and root, as well as an increased awareness of the mechanisms leading to AR, aortic valve repair has progressively evolved from an anecdotal approach to a plausible alternative to aortic valve replacement. Several studies have indeed demonstrated that aortic valve repair is feasible in a large number of patients with favorable AR lesions, such as root diseases or cusp prolapses, and results in a low incidence of valve-related complications, including reoperations. Valve lesions are thus critical data for the surgeon to determine the likelihood of valve sparing or repair surgery. This underscores the importance of the preoperative assessment of the functional anatomy of AR.