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J Cardiovasc Surg (Torino). 2008 Apr;49(2):297-303.

Aortic valve stenosis and regurgitation: an overview of management.

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  • 1Center for Aortic Surgery, Marfan and Connective Tissue Disorder Clinic, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH 44195, USA. svenssl@ccf.org


There are few cardiovascular disease entities that have as an impressive contribution to improved quality and duration of life as aortic valve disease correction. Although aortic valve stenosis is fairly common, particularly in elderly patients, between one third and two thirds go untreated, despite operative survival rates with the minimal invasive J incision approach of 99%. For those patients with high risk co-morbidity or technical inoperable reasons, the percutaneous transfemoral or transapical approaches are now available with good initial


For younger patients with tricuspid valves or bicuspid valves and aortic regurgitation, aortic valve repair should be the first choice procedure and with careful selection of the appropriate approach based on analysis of the patients CLASS (Commissure, Leaflet, Annulus, Sinotubular junction, and Sinuses) anatomy. Excellent results can be obtained with better than 90% freedom from reoperation at 10 years. The scope of procedures for aortic valve disease has increased markedly over the last 10 years and patients and cardiovascular physicians need to be aware of these newer options.

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