Aortic valve stenosis. Management in children and adults

Aortic valve stenosis may be congenital or acquired. Medical management includes advice to avoid heavy physical effort, prevention of infective endocarditis, use of digitalis and diuretics for cardiac failure, and preservation of atrial systole. When operation is necessary, open aortic valve commissurotomy is preferred in children and replacement of the valve is preferred in adults. Women of childbearing age should use conventional barrier contraceptives, and those with severe stenosis should have valve replacement before becoming pregnant. Aortic valvuloplasty, particularly in adults, is only of temporary benefit.