Deciding when to operate on a patient with chronic aortic regurgitation may
be extremely difficult. The timing of surgery requires consideration of th
e etiology and pathophysiology of the aortic regurgitation, because aortic
valve replacement carries morbidity and mortality that must be weighed agai
nst the potential problems of continued medical management. Guidelines for
the use of surgery in patients with valvular disease have been developed by
a joint task force of the American College of Cardiology and the American
Heart Association. Practical recommendations based on these guidelines are
presented.