Chronic Aortic Regurgitation

Sir Dominic Corrigan's classic monograph "On Permanent Patency of the Mouth of the Aorta, or Inadequacy of the Aortic Valves" was published in 1832. Descriptions of aortic regurgitation had previously been published by others, but Corrigan's contribution was so comprehensive that his name is still closely associated with this disorder. He described the physical findings and the underlying gross pathologic anatomy of aortic regurgitation. He recognized that sudden death was not characteristic of aortic regurgitation, as it was in aortic stenosis, and his therapeutic approach was based on firm physiologic principles. In the past 150 years we have expanded Corrigan's work, and we have developed a detailed appreciation of the natural history, pathophysiology, diagnostic methods, and treatment of chronic aortic regurgitation. Fifteen years ago, cardiac catheterization and angiography had already achieved widespread application in the evaluation of aortic regurgitation, but cardiac ultrasound, especially Doppler echocardiography, was in its infancy, and the utility of radionuclide ventriculography was not widely appreciated.

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1. Natural History of Aortic Regurgitation.- 2. Left Ventricular Geometry and Wall Stress in Chronic Aortic Regurgitation.- 3. End-Systolic Stress Volume Relationships in Chronic Aortic Regurgitation.- 4. Left Ventricular Structure and Function in Chronic Aortic Regurgitation.- 5. The left Ventricular Response to Static and Dynamic Exercise in Chronic Aortic Regurgitation.- 6. Quantitation of Aortic Regurgitation.- 7. Echocardiographic and Doppler Techniques in the Diagnostic and Therapeutic Evaluations of Chronic Aortic Regurgitation.- 8. Vasodilator Therapy of Chronic Aortic Regurgitation.- 9. Prediction of the Left Ventricular Response to Surgical Correction of Chronic Aortic Regurgitation: The Ratio of Regurgitant Volume to End-Diastolic Volume.- 10. Optimal Timing of Aortic Valve Replacement.- 11. Surgical Treatment of Chronic Aortic Regurgitation.- 12. Cardiovascular Function After Correction of Chronic Aortic Regurgitation.- 13. Late Results and Complications of Prosthetic Aortic Valves.