Surgery for valvular aortic stenosis

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.