Final answer:
Aortic valve replacement is indicated for severe aortic stenosis when the patient experiences symptoms such as chest pain or heart failure, has a decreased left ventricular ejection fraction, or shows severe AS in echocardiographic findings. Treatment options include traditional surgery or less invasive procedures like TAVR, based on patient risk and anatomy.
Step-by-step explanation:
Aortic Valve Replacement and Severe Aortic Stenosis
Aortic valve replacement (AVR) is a surgical procedure that is most commonly indicated for the treatment of severe aortic stenosis (AS). Aortic stenosis is a condition characterized by the narrowing of the aortic valve opening, which can lead to restricted blood flow from the left ventricle to the aorta and onwards to the rest of the body. Severe aortic stenosis can result in significant symptoms and complications that often necessitate valve replacement.
Indications for AVR in severe AS primarily include:
- Symptomatic severe AS, including symptoms such as chest pain (angina), syncope (fainting), and heart failure symptoms like shortness of breath.
- Decreased left ventricular ejection fraction (LVEF) indicating that the heart's pumping ability is compromised.
- Severe AS diagnosed by echocardiographic findings with a valve area of less than 1.0 cm² or a mean gradient greater than 40 mmHg.
- New occurrence of symptomatic arrhythmias or ventricular dysfunction.
Patients considered for AVR should undergo thorough evaluation to determine the best approach, whether through traditional open-heart surgery or less invasive techniques like transcatheter aortic valve replacement (TAVR). The choice of treatment depends on the patient's individual risk profile and anatomical considerations.