surgery for valvular aortic stenosis
Last reviewed 11/2021
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.