What are the approach considerations in the treatment of aortic regurgitation (AR)?

Updated: Nov 19, 2018
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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In severe acute aortic regurgitation (AR), surgical intervention is usually indicated, but the patient may be supported medically with dobutamine to augment cardiac output and shorten diastole and with sodium nitroprusside to reduce afterload in hypertensive patients.

Vasodilator therapy may be used on an inpatient or outpatient basis under conditions described in the current ACC/AHA guidelines. [4]

All patients with an artificial heart valve should receive antibiotic prophylaxis prior to dental procedures. For antithrombotic therapy, all patients with an artificial heart valve should receive daily aspirin, and many should also receive oral anticoagulation therapy. [4]

Although diuretics, nitrates, and digoxin are sometimes used to help control symptoms in patients with AR, not enough data in the clinical literature justify routinely recommending or discouraging these therapies. Also, no data support drug therapy of any class in patients with less than severe AR. [4]

Intra-aortic balloon counterpulsation, which can be used to provide temporary mechanical circulatory support, is contraindicated in patients with severe AR.

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