decision criteria for aortic valve replacement?

Question

surgery before or after cardiac symtoms occur?

Answer 1

I have searched this article for you, it will help you out:

Aortic valve replacement (AVR) is occasionally required in infants and children. Common indications for AVR in children include management of the following:

* Hypoplasia of the aortic valve in the neonate

* Progressive stenosis of the aortic valve in infants and children

* Multilevel left ventricular outflow tract (LVOT) obstruction in association with aortic valve stenosis not amenable to aortic valve repair for which enlargement of the outflow tract is required

* Aortic insufficiency as a complication of percutaneous balloon aortic valvuloplasty

* Rheumatic aortic valve disease

* Aortic valve endocarditis

Although the ideal aortic valve substitute does not exist, desirable characteristics include the following:

* Excellent flow hemodynamics with reduction of left ventricular afterload and/or preload to normal values

* Lifetime durability without the need for repeat operation because of structural deterioration

* No need for anticoagulation

* No risk for late embolic complications

* Ability to grow to avoid patient-prosthesis mismatch as the child ages

* Resistance to infection and endocarditis

* Ease of implantation

* Appropriate sizes available for all patients

Mechanical valve prostheses are not ideal valve substitutes in children. Although the incidence of structural valve deterioration is negligible, these prostheses have substantial limitations at the time of implantation because of the lack of appropriately sized prostheses for small children and neonates. In addition, the absence of the potential for growth can result in patient-prosthesis size mismatch as the child grows, and repeat replacement may be needed. Moreover, mechanical valves require lifetime anticoagulation with its associated activity limitations, difficulties with future pregnancy, and lifetime risk of thromboembolic and bleeding complications.

Homografts and bioprosthetic valves are also problematic in children. Although these biologic valves do not require anticoagulation, they also do not allow for growth. Also, their durability is limited in the pediatric population because of the high risk of accelerated structural valve degeneration and early calcification. In addition, limited availability of appropriately sized homografts and bioprostheses can be a problem.

Answer 2

I have aortic insufficiency myself, actually all of the valves in my heart leak. I am 39 years old and take 5 pills a day to help my heart function. I was told they wait until your Lv ejection fraction goes down is a good indicator. I was told the right side of my heart was starting to fail. Getting stiff as the doc described it to me. I was also told the valves only last about 10 years so they don't like to replace them at a young age unless absolutely necessary. I hope they don't wait to long. It's scary to say the least. What problem are you having with your heart?
Best of luck to you
Lisa