Pavol Chňupa
Aortic regurgitation (AR) is not the most frequent type of valvular heart disease are aortic stenosis or mitral regurgitation. However for the clinical cardiologist AR represents a serious problem related to the diagnostic and therapeutic approach. In echocardiography limited image quality of the aortic valve is present compared to the mitral valve, which results in problems with detailed evaluation of pathomorphological characteristics on the aortic valve and aortic root. The problem is also the exact quantification of the severity of regurgitation. In the article we would like to focus on the pitfalls associated with quantification of this valvular heart disease, current possibilities and limitations of imaging diagnostic investigations. Very frequently it is necessary to combine more diagnostic procedures to establish the severity and the stage of the disease, and also to establish the prognosis and the optimal treatment of the patient with AR. Opportunities of the pharmacological treatment of severe AR are very limited and the outcomes in the group of patients with AR treated pharmacologically are very inconclusive. That is why we would like to highlight the importance of the optimal timing of surgical intervention, especially in asymptomatic patients with AR. There is a high risk of complications in a delayed indication for surgery – aortic valve replacement or aortic valve repair. Perioperative mortality in this group of patients is significantly higher, postoperative outcome is worse due to irreversible dilatation and dysfunction of left ventricle. The prognosis of this group of patients is worse in both morbidity and mortality.