Congenital Aortic Valve Stenosis: When Is Surgery Recommended?

Congenital aortic valve stenosis is a heart condition that affects the aortic valve from birth. In most cases, doctors recommend waiting until the patient reaches adulthood before undergoing aortic valve surgery. This is primarily because the majority of patients with this condition will eventually require a valve replacement, and performing the procedure too early can lead to complications as the body grows and develops.

Why Adult Surgery Is Preferred

Artificial heart valves used in replacement surgery are not able to grow along with the patient's body. If a child undergoes valve replacement too early, they may outgrow the artificial valve, which could necessitate additional surgeries later in life. Waiting until adulthood ensures that the chosen valve will be more suitable for the patient's fully developed heart size and structure.

Choosing the Right Valve for Women

For female patients, especially those planning to have children in the future, selecting the appropriate type of valve is crucial. Biological valves are often recommended because they do not require lifelong anticoagulation therapy. Patients typically only need to take blood-thinning medication for about six months after surgery, making it a safer option for future pregnancies and childbirth. However, it's important to note that biological valves have a limited lifespan of approximately 15 to 20 years, meaning another surgery may eventually be necessary.

Minimally Invasive Treatment Options

Thanks to advancements in medical technology, less invasive treatment options are now available for patients with aortic valve stenosis. One such procedure is TAVI (Transcatheter Aortic Valve Implantation), also known as TAVR (Transcatheter Aortic Valve Replacement). This technique allows doctors to replace the aortic valve without open-heart surgery, significantly reducing recovery time and surgical risk. TAVI is particularly beneficial for patients who need a second operation, as it minimizes trauma and improves overall outcomes.