Aortic Valve Disease

	Stenotic aortic valve Do I need surgery? If you have aortic stenosis, surgery should be considered if you have symptoms such as chest pain, fainting, or irregular heart rhythm. Surgery is also recommended if the valve becomes more narrow over time.

The aortic valve is subject to life-long stress and may become narrowed (stenotic) with age. Aortic valve stenosis occurs earlier in life if the valve is congenitally malformed (unicuspid or bicuspid). Typically, a stenotic aortic valve will require replacement with a prosthetic valve.

Less commonly, the aortic valve will leak (insufficiency or regurgitation). Such valves can often be repaired using valve-sparing operations that reconstruct the valve leaflets and surrounding structures.

Young, active individuals may be suitable candidates for aortic valve replacement using their own pulmonary valve. This operation is known as the Ross procedure or pulmonary autograft operation. The patient's pulmonary valve is then replaced with a donor human pulmonary valve.

Patients desiring to avoid anticoagulation can select aortic valve replacement with a tissue bioprosthesis. Several excellent valves are currently available and used by Dr. Doty, including cryopreserved aortic homografts (donor human valves) and the Medtronic Freestyle porcine bioprosthesis.

Factors to consider when selecting a valve prosthesis include:

• lifestyle
• possibility of future operations
• desire to avoid anticoagulation
• underlying cause of aortic valve disease