Aortic valvular disease in adults. A potentially lethal clinical problem

Patients who have asymptomatic aortic valvular disease with normal systolic ventricular function need careful follow-up, because both aortic stenosis and aortic regurgitation are potentially life-threatening. Medical therapy may be helpful for long-term management of patients with chronic aortic regurgitation, but valve replacement should be done before heart failure or refractory left ventricular dilatation develops. Aortic valve replacement is recommended in patients with symptomatic, severe aortic stenosis because of the high risk of sudden death if left untreated. Once valve replacement is indicated for either aortic stenosis or regurgitation, a choice must be made between a mechanical and a bioprosthetic valve, although allografts and autografts may become more widely used in the future.