What are the indications for surgical intervention in patients with aortic regurgitation?

Indications for surgical intervention in patients with aortic regurgitation include:

• Adults with symptomatic severe aortic regurgitation should be offered surgery if suitable.
• Adults with asymptomatic severe aortic regurgitation should be considered for referral for intervention if they have either a left ventricular ejection fraction (LVEF) less than 55% or an end systolic diameter (ESD) greater than 50 mm or an end systolic diameter index (ESDI) greater than 24 mm/m² on echocardiography.

Surgery is typically offered by median sternotomy or minimally invasive surgery depending on patient suitability and preferences.

Decisions about timing and type of surgery should be based on clinical assessment, echocardiographic parameters, and shared decision making with the patient.

These recommendations are based on evidence that early intervention in patients with declining ventricular function or significant ventricular dilation improves outcomes.

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