Aortic valve regurgitation — also called aortic regurgitation — is a type of heart valve disease. The valve between the lower left heart chamber and the body's main artery doesn't close tightly. As a result, some of the blood pumped out of the heart's main pumping chamber, called the left ventricle, leaks backward.

The leakage may prevent the heart from doing a good enough job of pumping blood to the rest of the body. You may feel tired and short of breath.

Aortic valve regurgitation can develop suddenly or over many years. Once the condition becomes severe, surgery often is needed to repair or replace the valve.

The aortic valve is one of four valves that control blood flow through the heart. It separates the heart's main pumping chamber, called the left ventricle, and the body's main artery, called the aorta. The aortic valve has flaps, also called cusps or leaflets, that open and close once during each heartbeat.

In aortic valve regurgitation, the valve doesn't close properly. This causes blood to leak back into the lower left heart chamber, called the left ventricle. As a result, the chamber holds more blood. This could cause it to get larger and thicken.

At first, the larger left ventricle helps maintain good blood flow with more force. But over time, the heart becomes weak.

Any condition that damages the aortic valve can cause aortic valve regurgitation. Causes may include:

• Heart valve disease present at birth. Some people are born with an aortic valve that has only two cusps or with connected cusps, rather than the typical three separate ones. In either situation, the condition is called a bicuspid valve. Sometimes the valve may have only one cusp, called a unicuspid valve. Other times, there are four cusps, called a quadricuspid valve.

  Having a parent or sibling with a bicuspid valve raises your risk of the condition. But you can have a bicuspid valve even if you don't have a family history of the condition.

• Narrowing of the aortic valve, called aortic stenosis. Calcium deposits can build up on the aortic valve as you age. The buildup causes the aortic valve to stiffen and become narrow. It prevents the valve from opening properly. Aortic stenosis also may prevent the valve from closing properly.
• Inflammation of the inner lining of the heart's chambers and valves. This life-threatening condition also is called endocarditis. It's usually caused by an infection. It can damage the aortic valve.
• Rheumatic fever. This condition was once a common childhood illness in the United States. Strep throat can cause it. Rheumatic fever can cause the aortic valve to become stiff and narrow. That in turn causes blood to leak. If you have an irregular heart valve due to rheumatic fever, it's called rheumatic heart disease.
• Other health conditions. Other rare conditions can cause the aorta to get bigger and damage the aortic valve. These include a connective tissue disease called Marfan syndrome that is present at birth. Some immune system conditions, such as lupus, also can lead to aortic valve regurgitation.
• Tear or injury of the body's main artery. The body's main artery is the aorta. A traumatic chest injury may damage the aorta and cause aortic regurgitation. So might a tear in the inner layer of the aorta, called an aortic dissection.

Treatment of aortic valve regurgitation depends on:

• How serious the condition is.
• The symptoms, if any.
• Whether the condition is getting worse.

The goals of aortic valve regurgitation treatment are to ease symptoms and prevent complications.

If your symptoms are mild or you don't have symptoms, you may only need regular health checkups. You may need regular echocardiograms to check the health of the aortic valve. Heart-healthy lifestyle changes also are usually recommended.

Medications

If you have aortic valve regurgitation, you may be given medicines to:

• Treat symptoms.
• Lower the risk of complications.
• Lower blood pressure.

Surgery or other procedures

Surgery may be needed to repair or replace the diseased valve, especially if the condition and symptoms are severe. Heart valve surgery may be needed even if aortic regurgitation isn't severe or when there are no symptoms.

The decision to repair or replace a damaged aortic valve depends on:

• Your symptoms.
• Your age and overall health.
• Whether you need heart surgery to correct another heart condition.

If you're having another heart surgery, surgeons may do aortic valve surgery at the same time.

Surgery to repair or replace an aortic valve may be done as open-heart surgery. This involves a cut, also called an incision, in the chest. Sometimes surgeons can replace the aortic valve through smaller cuts. This is known as minimally invasive heart surgery.

Surgery for aortic valve regurgitation includes:

• Aortic valve repair. To repair an aortic valve, surgeons may separate valve flaps that have connected. These flaps also are called cusps. The surgeons might reshape or remove excess valve tissue so that the cusps can close tightly. Or they might patch holes in a valve. A catheter treatment may be done to place a plug or device in a leaking replacement aortic valve.

• Aortic valve replacement. The surgeon removes the damaged valve and replaces it. The replacement might be a mechanical valve or one made from cow, pig or human heart tissue. A tissue valve also is called a biological tissue valve.

  Sometimes, surgeons can do minimally invasive heart surgery to place a tissue valve inside a damaged valve. This treatment is called transcatheter aortic valve replacement, also known as TAVR. It uses smaller incisions than those used in open-heart surgery. This treatment also may be called transcatheter aortic valve implantation, also called TAVI for short.

  Sometimes the aortic valve is replaced with your own lung valve, also called the pulmonary valve. Your pulmonary valve is replaced with a biological lung tissue valve from a deceased donor. This more complicated surgery is called the Ross procedure.

  Biological tissue valves break down over time. Someday, they may need to be replaced. People with mechanical valves need blood thinners for life to prevent blood clots. Ask your healthcare team about the benefits and risks of each type of valve.

Treatment of aortic valve regurgitation depends on:

• How serious the condition is.
• The symptoms, if any.
• Whether the condition is getting worse.

The goals of aortic valve regurgitation treatment are to ease symptoms and prevent complications.

If your symptoms are mild or you don't have symptoms, you may only need regular health checkups. You may need regular echocardiograms to check the health of the aortic valve. Heart-healthy lifestyle changes also are usually recommended.

Medications

If you have aortic valve regurgitation, you may be given medicines to:

• Treat symptoms.
• Lower the risk of complications.
• Lower blood pressure.

Surgery or other procedures

Surgery may be needed to repair or replace the diseased valve, especially if the condition and symptoms are severe. Heart valve surgery may be needed even if aortic regurgitation isn't severe or when there are no symptoms.

The decision to repair or replace a damaged aortic valve depends on:

• Your symptoms.
• Your age and overall health.
• Whether you need heart surgery to correct another heart condition.

If you're having another heart surgery, surgeons may do aortic valve surgery at the same time.

Surgery to repair or replace an aortic valve may be done as open-heart surgery. This involves a cut, also called an incision, in the chest. Sometimes surgeons can replace the aortic valve through smaller cuts. This is known as minimally invasive heart surgery.

Surgery for aortic valve regurgitation includes:

• Aortic valve repair. To repair an aortic valve, surgeons may separate valve flaps that have connected. These flaps also are called cusps. The surgeons might reshape or remove excess valve tissue so that the cusps can close tightly. Or they might patch holes in a valve. A catheter treatment may be done to place a plug or device in a leaking replacement aortic valve.

• Aortic valve replacement. The surgeon removes the damaged valve and replaces it. The replacement might be a mechanical valve or one made from cow, pig or human heart tissue. A tissue valve also is called a biological tissue valve.

  Sometimes, surgeons can do minimally invasive heart surgery to place a tissue valve inside a damaged valve. This treatment is called transcatheter aortic valve replacement, also known as TAVR. It uses smaller incisions than those used in open-heart surgery. This treatment also may be called transcatheter aortic valve implantation, also called TAVI for short.

  Sometimes the aortic valve is replaced with your own lung valve, also called the pulmonary valve. Your pulmonary valve is replaced with a biological lung tissue valve from a deceased donor. This more complicated surgery is called the Ross procedure.

  Biological tissue valves break down over time. Someday, they may need to be replaced. People with mechanical valves need blood thinners for life to prevent blood clots. Ask your healthcare team about the benefits and risks of each type of valve.