Harvard Heart Letter

Aortic valve disease: Surgical or transcatheter replacement?

Some 1.5 million Americans have aortic valve stenosis—calcification of the valve that must open for blood to surge from the heart to the rest of the body. As the valve stiffens, blood flow slows. Symptoms include chest pain, shortness of breath, and fainting; once symptoms occur, the two-year death risk is 50%. Valve replacement via open-heart surgery is the gold standard, but 30% to 40% of people cannot withstand the procedure. Transcatheter aortic valve replacement now is available for them. Although the new procedure greatly shortens recovery time, U.S. cardiologists consider it too soon to offer the approach to people capable of undergoing surgery.
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