Indications for surgery in a patient with aortic regurgitation:
(1) severe aortic regurgitation AND symptomic (dyspnea OR angina OR NYHA II to IV)
(2) severe aortic regurgitation AND resting left ventricular ejection fraction (LVEF) <= 50%
(3) severe aortic regurgitation AND resting LVEF > 50% AND left ventricular dilatation (end-diastolic diameter > 70 mm OR end-systolic diameter > 25 mm per square meter BSA)
(4) severe aortic regurgitation AND needs surgery for another reason (CABG OR other valve replacement OR significant disease in the ascending aorta)
(5) any aortic regurgitation AND disease of the aortic root AND Marfan's syndrome AND aortic diameter >= 45 mm
(6) any aortic regurgitation AND disease of the aortic root AND bicuspid aortic valve AND aortic diameter >= 50 mm
(7) any aortic regurgitation AND disease of the aortic root AND aortic diameter >= 55 mm
A patient may be considered for surgery with less advanced disease if experienced surgeons are available.
