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Surgery for valvular aortic stenosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Symptomatic aortic stenosis should be treated by valve replacement. The aim is to replace a severely stenosed valve before symptoms appear because a damaged left ventricle never completely returns to normal functioning. In contrast, it is never too late to replace the valve.

Indications for surgery include:

  • symptomatic indicators e.g. angina, syncope
  • if the patient is asymptomatic then surgery in indicated if there is a significant peak gradient e.g. greater than 50 mm Hg or reduction of Gorlin valve area e.g. less than 0.5 square centimetres
  • to prevent irreversible left ventricular damage e.g. dilation of left ventricle on chest X-ray

Possible operations include:

  • infants - balloon angioplasty
  • children - congenital stenosis may be treated by open aortic valvotomy on cardiopulmonary bypass
  • adults - aortic valve replacement

Asymptomatic patients should be advised to avoid competitive sports.

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