Aortic Insufficiency/Regurgitation

Aortic regurgitation occurs when the aortic valve doesn’t close properly. This is also known as aortic insufficiency or a leaky aortic valve because it lets blood leak back into the heart. 


Many people with aortic valve disease do not experience any symptoms. As the disease progresses, you may notice a general decline in activity level. Other symptoms may include:

  • Chest pain or tightness
  • Dizziness, lightheadedness or fainting
  • Fatigue, especially with activity
  • Rapid or irregular heartbeat
  • Shortness of breath or difficulty breathing when lying down


Aortic valve diseases can be present at birth (congenital) or acquired later in life.

Bicuspid aortic valve is the most common genetic abnormality of the aortic valve. A bicuspid aortic valve has two leaflets instead of three. The valve may function well for many years or a lifetime. If stenosis develops or it becomes leaky, the valve may need repair or replacement. Find out more about bicuspid aortic valve.

Aortic valve disease can also be caused by:

  • Age-related buildup of calcium that causes the valve to become narrow and stiff (stenosis)
  • Heart conditions such as a prior heart attack or high blood pressure that can damage the aortic valve
  • High-dose radiation from cancer treatment
  • Infections such as rheumatic fever or infective endocarditis (an infection of inner lining of the heart that can also involve the heart valves)


At the Frankel Cardiovascular Center, our team will work with you to assess your symptoms and make an accurate diagnosis. You will have most of your tests done under one roof and frequently in one visit.

Diagnosing aortic valve disease starts with a health assessment, review of your medical history and physical exam. Your doctor will also listen to your heart for a whooshing sound (murmur), a sign of heart valve disease.

Other tests our doctors use to diagnose aortic valve diseases include:

  • Cardiac computerized tomography (CT) scan which creates a detailed image of your heart and valves using a special type of X-ray.
  • Chest X-ray which shows your aorta and calcium buildup on the aortic valve.
  • Coronary angiography which takes an X-ray of your heart and valves after a special dye is injected into your heart through a catheter inserted into a blood vessel in your arm or groin and guided to your heart.
  • Echocardiogram which produces a video of your heart and valves in action using ultrasound waves. For a closer look, your doctor may order a transesophageal echocardiogram (TEE). A small ultrasound probe is inserted into your esophagus (tube that runs from the throat to the stomach) to get detailed images of your aorta and upper heart chambers.
  • Electrocardiogram (ECG) which tracks the electrical activity of your heart. An ECG can detect an irregular heartbeat and enlarged heart chambers.
  • Exercise or stress ECG test to measures how your heart responds to physical activity. If you cannot exercise, you can take a medication that mimics exercise.


At the Frankel Cardiovascular Center, you’ll receive care from a nationally recognized program. We are nationally ranked for Cardiology and Heart Surgery by U.S. News & World Report Best Hospitals. We have also received top scores for abdominal aortic aneurysm repair, aortic valve surgery and transcatheter aortic valve repair (TAVR).

We offer treatments that range from nonsurgical to minimally invasive to open surgery:

Nonsurgical Treatments for Aortic Valve Disease

Not all patients with aortic valve disease will require surgery. Depending on your age, health, condition and symptoms, we may recommend nonsurgical treatments such as medications and lifestyle changes.

Your doctor may prescribe medications to:

  • Improve cholesterol
  • Lower blood pressure
  • Prevent blood clots
  • Reduce stress on the heart

While these medications don’t cure aortic valve disease, they can control your symptoms and prevent further damage.

We can also work with you to implement lifestyle changes that may improve your condition. You may benefit from specialists who can help you quit smoking, improve your diet and be more physically active.

Transcatheter Aortic Valve Replacement (TAVR)

TAVR is a minimally invasive procedure for patients with severe aortic stenosis. In the past, TAVR was only approved for high-risk patients who were not candidates for open surgery. It is now approved for all patients. During TAVR, the doctor uses a catheter to insert a replacement valve inside the diseased valve. Because the procedure is minimally invasive, you have a faster recovery and a lower risk of postoperative infection. Learn more about TAVR.

Open Aortic Valve Surgery (SAVR)

Though many patients prefer minimally invasive procedures, sometimes open surgery — in which the surgeon uses a larger incision to directly access the heart — is the best option. At the Frankel Cardiovascular Center, our outcomes for open surgery are among the best in the nation.

During open surgery, the aortic valve can be replaced or repaired. Patients with stenosis typically require valve replacement. Leaky valves can often be repaired or replaced. Because replacement valves have a limited lifespan, surgeons prefer to repair a diseased aortic valve if possible, especially in younger patients.

Replacement valves can be mechanical (manufactured) or made of biological tissue. Mechanical valves last longer, but you must take blood thinners for the rest of your life to prevent blood clots.

Tissue valves are made of animal or human tissue. You don’t need to take blood thinners with this type of valve, but they have a shorter lifespan than mechanical valves.

A surgical aortic valve replacement procedure requires general anesthetic (the patient is asleep during the operation). During the procedure, an incision is made in the chest to access the heart. The length and location of the incision may vary depending on the type of surgical approach selected for the patient.

The heart is then stopped and a heart-lung (bypass) machine takes over the job of the heart during the operation. The diseased aortic valve is removed and replaced with a new valve. The heart is restarted and the opening in the chest is closed.

Like any type of major surgery, the SAVR procedure carries the risk of complications, including:

  • Infection
  • Blood clots
  • Stroke
  • Irregular heartbeat


Make an Appointment

To schedule an evaluation with a Frankel Cardiovascular Center physician, call 888-287-1082. Or visit the Make a Cardiovascular Appointment page to learn what to expect when you call us.

Physicians: To refer a patient, call M-Line at 800-962-3555.