Surgery should be considered if there is a pressure gradient across the stenosis of 50 - 60 mm Hg especially in the presence of left ventricular or septal hypertrophy. Unfortunately, surgery may cause aortic incompetence.
Systemic hypertension is common after relief of the aortic stenosis, however, renal artery stenosis should be excluded as a matter of course.
Radical surgery for diffuse stenosis includes total aortic root and aortic valve replacement with reimplantation of the coronary arteries.
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