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Indications For Surgery : The normal aortic valve area in the adult is about 3-4 cm2. Significant symptoms occur when the valve area is seduced to 1/4"' the normal area of the aortic valve. The severity of aortic stenosis is graded by valve area or peak valvar pressure gradient.
Even when aortic stenosis is critical, in the presence of LV dysfunction, the gradient may be deceptively low. Similarly, some patients with severe aortic stenosis may be asymptomatic.
Aortic stenosis patients usually present with angina, syncope or dyspnoen. In all symptomatic patients who do not have any serious co morbid conditions surgery is indicated. Even in those patients with severe LV dysfunction, operation should be performed, if they have anatomically severe stenosis. AVR in such cases results in haemo dynamic improvement and better functional status.
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