Update in aortic valve diseases

Aortic valve disease is currently the commonest valve disease. The prevalence of aortic stenosis reaches 2% to 5% of very elderly patients. It is the second commonest indication for cardiac surgery, and the commonest indication for valve surgery today. In the European survey, aortic valve disease constituted 60% of all valve diseases. There are two important reasons for this finding: 1) 1-2% of the population is born with bicuspid aortic valve 2) the ageing population is growing to the stage where significant degenerative aortic valve disease is developing. Although the disease is associated with substantial clinical consequences, there is currently no effective therapy for the disease other than surgical aortic valve replacement. This review focuses on innovations in the pathophysiology, diagnosis and treatment of aortic valve diseases (stenosis and regurgitation) with special emphasis on the new ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A comparison with the older ACC/AHA guidelines and the European guidelines is also presented.