Congenital Aortic Valve Stenosis: When Should Surgery Be Performed?

Congenital aortic valve stenosis is a heart condition that affects the aortic valve from birth. In most cases, doctors recommend undergoing aortic valve surgery in adulthood. This is primarily because early intervention may not be sustainable as the body continues to grow and develop.

Why Surgery Is Delayed Until Adulthood

When dealing with congenital aortic stenosis, timing is crucial. Performing valve replacement too early can result in complications later in life, as artificial valves may not grow with the patient. Therefore, waiting until full physical development is usually considered the best approach.

Valve Replacement Options for Adults

Most patients with significant aortic stenosis will eventually require valve replacement. For women of childbearing age, a biological valve is often the preferred option. This allows for future pregnancy and family planning without long-term complications. Typically, patients with a bioprosthetic valve require anticoagulant therapy for about six months after surgery, which is a relatively short duration compared to mechanical valves.

Limitations of Biological Valves

While biological valves offer advantages for younger patients, especially women planning to have children, they do come with a limited lifespan. Most bioprosthetic valves last between 15 to 20 years, meaning patients may need a second procedure later in life.

Minimally Invasive Treatment Options

Thanks to medical advancements, minimally invasive procedures are now available for patients with aortic valve disease. One such innovation is TAVI (Transcatheter Aortic Valve Implantation), also known as TAVR (Transcatheter Aortic Valve Replacement). This procedure is particularly beneficial for patients who require a second surgery, as it significantly reduces recovery time and surgical risk.

Benefits of TAVI for Repeat Procedures

For patients who have already undergone one valve replacement and may need another, TAVI offers a less invasive alternative to traditional open-heart surgery. It allows for quicker recovery and fewer complications, making it an excellent option for both younger and older patients alike.