Early surgery best for leaky heart valves

Patients with leaky aortic valves should have them replaced before the onset of significant symptoms, new guidelines suggest.

Scientists from the American College of Cardiology and the American Heart Association have outlined the specific criteria for operating on patients with aortic regurgitation, which has proved to be effective in increasing survival time and general health in recent tests.

“In short, we found that those patients that were operated on early enough following the specific criteria of the guidelines (that is, also assuring that they were not given a too early operation), survived for a longer time and had better health than those patients who were referred for operation in later stages of the disease,” said Dr Pilar Tornos from the Hospital Universitari Vall d’Hebron in Barcelona, Spain.

The guidelines suggest early surgery to pre-empt any symptoms caused by a leaky heart valve.

The study conducted by Dr Tornos examined 170 patients with chronic severe aortic regurgitation ? 60 of which were given early surgery according to the guidelines.

Results showed that after an average of ten years, seven patients (12 per cent) from the early surgery group had died compared to 37 deaths (37 per cent) in the later surgery group.

Dr Tornos concluded that although operating early may be obvious, this is not always the best course of action.

She said: “While too late means a worse prognosis, too early, that is, operating on patients with a more delayed risk of deterioration, would mean an unnecessary surgical procedure and additional years of anticoagulation therapy, which is in itself somewhat hazardous.

“So a properly timed waiting period may be needed.”

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